At Pandya Medical Center, this role supports accurate medical billing and coding within a busy outpatient medical practice in North Atlanta. The specialist will ensure encounters are coded correctly before claims are created, help maximize accurate third-party reimbursement, reduce denials, and support the revenue cycle. The position is based on-site in the Johns Creek area of Georgia and includes strong growth opportunities in a patient-focused clinical environment.
Key Responsibilities
- Submit medical claims accurately and on time to insurance companies and other payers
- Review medical records to ensure appropriate diagnosis and procedure coding
- Identify and document insufficient or unclear claim information for providers and management
- Assign or update CPT, HCPCS, and ICD-10-CM codes and modifiers as needed
- Follow up on unpaid claims and initiate appeals for denied claims within required timelines
- Track claims through the clearinghouse and resolve issues promptly
- Assist patients with billing questions by phone and email
- Maintain current knowledge of healthcare regulations, medical terminology, and coding practices
- Follow HIPAA guidelines when handling patient information
- Complete additional job-related duties and projects as assigned
Requirements & Qualifications
- Minimum of 3 years of experience in medical billing and revenue cycle work in a medical setting
- Certified Professional Coder (CPC) through AAPC
- Knowledge of HMO/PPO plans, Medicare, and other payer requirements
- Strong understanding of CPT, ICD-10, HCPCS coding, and modifiers
- Working knowledge of medical billing rules, EOBs, and ERAs
- Proficiency with computers and Microsoft Office or similar software
- Experience with AthenaHealth EHR preferred; Epic or eClinicalWorks also helpful
- Family practice or primary care outpatient billing experience preferred
- Strong customer service skills for interacting with patients about claims and payments
- Ability to multitask, prioritize, and work effectively in a fast-paced team environment
- Strong problem-solving skills for resolving discrepancies, denials, appeals, and collections
- Solid understanding of HIPAA and patient confidentiality
Benefits & Perks
- Health insurance
- Dental and vision plans
- Aflac supplemental insurance plans
- 401(k) match up to 4%
- Paid time off
Location
Georgia, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 week ago