Billing/Certified Coder

Billing/Certified Coder

The Billing/Certified Coder at Aesthetic Surgery Centre, PLLC plays a critical role in ensuring accurate and efficient medical billing and coding processes that directly impact the financial health of the practice. This position involves meticulously reviewing patient records and surgical documentation to assign appropriate medical codes for procedures and diagnoses in compliance with regulatory standards. The role requires collaboration with clinical staff to clarify documentation and resolve coding discrepancies, thereby optimizing reimbursement and minimizing claim denials. The successful candidate will manage billing submissions, follow up on unpaid claims, and maintain up-to-date knowledge of coding guidelines and payer policies. Ultimately, this position supports the center's mission by facilitating smooth revenue cycle operations and contributing to high-quality patient care through precise administrative practices.

Minimum Qualifications:

• Certified Professional Coder (CPC) or equivalent certification from a recognized coding organization.
• Minimum of 3 years of experience in medical billing and coding, preferably in a surgical or aesthetic practice setting.
• Strong understanding of CPT, ICD-10, and HCPCS coding systems and medical terminology.
• Proficiency with electronic health record (EHR) systems and medical billing software.
• Knowledge of insurance claim processes, payer requirements, and healthcare compliance regulations.

Preferred Qualifications:

• Experience working in an aesthetic surgery or cosmetic medical practice.
• Additional certifications such as Certified Coding Specialist (CCS) or Certified Professional Medical Auditor (CPMA).
• Familiarity with Medicare, Medicaid, and private insurance billing nuances specific to surgical procedures.
• Advanced skills in data analysis and reporting related to billing and coding metrics.
• Strong interpersonal skills to effectively communicate with clinical and administrative teams.

Responsibilities:

• Review and analyze medical records and surgical reports to accurately assign CPT, ICD-10, and HCPCS codes.
• Prepare and submit claims to insurance companies and government payers, ensuring compliance with billing regulations.
• Collaborate with physicians, nurses, and administrative staff to clarify documentation and resolve coding issues.
• Monitor claim status, follow up on unpaid or denied claims, and work to resolve discrepancies promptly.
• Maintain current knowledge of coding standards, payer policies, and regulatory requirements to ensure compliance.
• Audit billing and coding processes regularly to identify areas for improvement and ensure accuracy.
• Assist in training staff on coding and billing procedures as needed.

Skills:

The required skills enable the Billing/Certified Coder to accurately interpret clinical documentation and translate it into standardized codes that are essential for billing and reimbursement. Proficiency with coding systems and medical terminology ensures compliance with healthcare regulations and reduces claim denials. Familiarity with electronic health records and billing software facilitates efficient data entry and claim submission processes. Preferred skills such as experience in aesthetic surgery coding and advanced auditing capabilities enhance the ability to identify and correct errors proactively, improving revenue cycle performance. Strong communication and collaboration skills are used daily to liaise with clinical staff and payers, ensuring clarity and resolution of any billing or coding issues.