Job Summary:
We are seeking a detail-oriented surgical Biller and Coder with proven experience to lead the daily operations of our billing and coding department at our Babylon office. The ideal candidate will have strong leadership skills, a deep understanding of surgical billing and coding processes, and the ability to ensure accuracy, compliance, and efficiency across the department.
Key Responsibilities
Manage the end-to-end billing lifecycle for surgical and non-surgical services, from charge entry and claim submission through final resolution
Ensure timely and accurate submission of claims, medical records, and operative reports through payer and insurance portals
Monitor, analyze, and resolve claim denials, underpayments, and payment delays, including proactive follow-up to ensure timely reimbursement
Initiate, track, and manage reconsiderations, disputes, and first- and second-level appeals in accordance with payer guidelines
Perform consistent claim status follow-up to drive claims to resolution and minimize aging accounts receivable
Review and validate operative reports and clinical documentation to ensure coding accuracy, completeness, and compliance
Assign and oversee accurate CPT, ICD-10-CM, including appropriate modifier usage per CMS and payer rules
Conduct regular coding and billing audits to ensure compliance, reduce errors, and protect revenue integrity
Collaborate closely with providers, coders, and clinical staff to clarify documentation requirements and resolve complex coding or billing scenarios
Serve as a subject matter expert and escalation point for complex billing, coding, and payer-related issues
Be a self-starter, and flexibility and willingness to learn to use new EHR medical systems a must.
Qualifications:
Benefits:
Work Location: Hybrid, Babylon