Medical Coding and Billing Specialist

The Coding and Billing Analyst plays a pivotal role in our practice by accurately translating patient information into alphanumeric medical codes for inclusion in the patient's records. Ensuring compliance with HIPAA/OSHA standards, the employee utilizes expertise in coding systems such as HCPCS and ICD-10 to code procedures, maintain medical coding guidelines, and verify the completeness and accuracy of records. The location for this position is in our Wallingford office Monday-Friday.

Responsibilities:

• Code procedures accurately and input them into patient charts
• Ensure compliance with medical coding guidelines and policies
• Verify and code diagnoses, evaluations, and procedures for record completeness and accuracy
• Perform edit checks on entered data and correct errors before transmittal
• Communicate effectively with clinical staff, patients, and insurance companies regarding billing inquiries and payment arrangements
• Submit claims to insurance carriers and follow up on claim status, resubmitting if necessary
• Handle patient information with confidentiality, managing account payments and contributing to departmental efficient through creative problem-solving.

Qualifications:

• High school diploma or equivalent required; possession of a Certified Professional Coding license or active enrollment in a CPC course is preferred.
• In-depth knowledge of various coding systems including HCPCS and ICD-10.
• Familiarity with insurance-specific coding and billing rules and guidelines.
• Proficient in using medical billing software and electronic medical record (EMR) systems.
• Ability to handle complex or unusual coding cases and perform edit checks on entered data.