Analyze patient charts, physician notes and discharge summaries
Ensure documentation is complete and accurate before coding
Translate diagnoses and procedures into standardized codes using:
ICD-10-CM (diagnoses)
CPT (procedures)
HCPCS (supplies/services)
Make sure codes correctly represent services provided
Follow healthcare laws and regulations (HIPAA, Medicare/Medicaid guidelines) Company Policies
Prevent coding errors that could lead to claim denials or audits
Stay updated on coding changes and updates
Work with billing teams to submit coded claims to insurance companies
Verify claim accuracy to ensure proper reimbursement
Fix rejected or denied claims by reviewing and correcting codes
Communicate with healthcare providers and insurance companies
Protect sensitive patient information
Follow strict privacy and data security standards
Clarify documentation with physicians when needed
Collaborate with billing and administrative teams
Regularly update knowledge of coding systems and regulations
Maintain certification through continuing education
Perform coding audits and compliance reviews
Train new coders or staff
Specialize in areas like inpatient, outpatient, or specialty coding
All other duties as assigned.
Post charges into billing system within 24-48 hours and completes other billing functions under direction of supervisor
Identifies possible billing errors that might prevent the claim from being processed on the insurance company level
Verifies patient coverage and demographic information, draws conclusions, and corrects billing errors or other Claim issues
Contributes to improvement of billing procedures and processes
Escalates problem claims to management as required by circumstances
Communicate effectively with clinic/administrative personnel, assigned coder and CLT-Team
Completes assigned training and education
Qualifications
High School diploma or GED equivalent
Medical billing and coding training program -Certificate or associate degree Required
Demonstrates experience with medical billing, CPT and ICD-10 codes, Revenue Cycle
Ability to exercise discretion on sensitive and confidential matters
Demonstrate ability to communicate effectively on the phone, in writing and via email
Demonstrates computer skills with data entry software, Microsoft Word, and Excel
Institutional accreditation and degree obtainment will be verified upon hire
Knowledge of medical terminology, anatomy, and healthcare regulations
insurance, banking, hospital medical office or other experience with extensive customer service contact
One or more years of billing and coding experience in medical field- required in the medical field.
Bilingual Preferred
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.
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