Medical Billing Coder

Reviews billing data from medical office or hospital records to ensure amounts and account numbers are accurate. Responsible for account posting, collections, verifying patient benefits, accurate diagnosis and procedure coding, and insurance pre-certifications, pre-authorizations, pre-determinations, and other required insurance notifications for procedures performed in the clinic.

Key duties include:

• Review and analyze patient records and physician documentation for completeness and accuracy, including radiology reports, neurological procedures, office visit notes, and laboratory results.
• Assign precise CPT, ICD-10, HCPCS, and when applicable APC/DRG codes to all services performed.
• Ensure codes are sequenced according to insurance and governmental regulations to support timely and accurate reimbursement.
• Maintain current knowledge of coding guidelines, compliance standards, and payer policy changes.
• Communicate with physicians and clinical staff to clarify documentation and improve coding compliance.
• Conduct chart audits and support internal or external coding reviews.
• Communicate coding issues or discrepancies to the supervisor or compliance officer.
• Train new staff and educate providers on documentation and coding improvements.
• Check and resolve assigned tasks in the EMR system.