The Medical Coding Specialist is responsible for billing analysis of claims and applying coding standards and federal regulations to ensure correct billing practices. This role performs bill and chart reviews to identify deviations from quality billing practices and monitors patient bills for accuracy and compliance. The position also supports global operations by working with international coding systems, healthcare billing practices, and cross-border regulatory standards.
Key responsibilities include reviewing inpatient, outpatient, and provider billing for medical appropriateness, applying national and international coding standards, researching claims and documentation, supporting internal claim recommendations, communicating findings with coworkers and management, assisting with staff education, monitoring coding and regulatory trends across regions, and ensuring compliance with HIPAA and international data protection regulations.
Applicants should have a medical license or coding certification, or a bachelor's degree in a healthcare-related field with at least 2 years of coding experience. Current certifications such as CCS, CCS-P, CPC, RHIA, or RHIT are preferred or required as applicable.
Candidates should have at least 2 years of experience in direct patient care, medical procedure billing, medical insurance auditing, line item review, audits, coding, or reimbursement. Strong knowledge of inpatient and outpatient billing requirements, professional claim billing, payer reimbursement policies, and state, federal, and international regulations is required.
Additional qualifications include:
- Familiarity with UB-04s, HCFA-1500s, CPT, HCPCS, ICD-9/10, DRG, APCs, and international equivalents
- Ability to read and abstract medical records
- Strong communication, teamwork, training, presentation, negotiation, and organizational skills
- Proficiency in MS Office Suite and database software
- Knowledge of medical terminology, anatomy, and physiology
- Ability to discuss audit results with providers and handle multiple tasks in a fast-paced environment
Benefits include:
- Medical, dental, and vision coverage with low deductible and copay
- Life insurance
- Short- and long-term disability
- Paid parental leave
- 401(k) with match
- Employee stock purchase plan
- Generous paid time off
- 10 paid company holidays
- Tuition reimbursement
- Flexible spending account
- Employee assistance program
- Sick time benefits
- Health insurance and bonus opportunity
Location
N/A
Employment Type
Full-time
Experience Level
Associate
Salary Range
$60,000 - $63,000
Remote work allowed
No
Posted
1 week ago