Analyze patient charts, physician notes, and discharge summaries.
Ensure documentation is complete and accurate before coding.
Translate diagnoses and procedures into standardized codes using ICD-10-CM, CPT, and HCPCS.
Make sure codes correctly represent services provided.
Follow healthcare laws and regulations, including HIPAA and Medicare/Medicaid guidelines.
Prevent coding errors that could lead to claim denials or audits.
Stay updated on coding changes and updates.
Work with billing teams to submit coded claims to insurance companies.
Verify claim accuracy to ensure proper reimbursement.
Fix rejected or denied claims by reviewing and correcting codes.
Communicate with healthcare providers and insurance companies.
Protect sensitive patient information and follow strict privacy and data security standards.
Clarify documentation with physicians when needed.
Collaborate with billing and administrative teams.
Maintain certification through continuing education.
Perform coding audits and compliance reviews.
Train new coders or staff.
Specialize in inpatient, outpatient, or specialty coding.
Post charges into the billing system within 24-48 hours and complete other billing functions under supervision.
Identify possible billing errors that may prevent claim processing.
Verify patient coverage and demographic information and correct billing errors or claim issues.
Contribute to improvements in billing procedures and processes.
Escalate problem claims to management as needed.
Communicate effectively with clinic and administrative personnel, assigned coders, and team members.
Complete assigned training and education.
All other duties as assigned.
High school diploma or GED equivalent.
Medical billing and coding training program, certificate, or associate degree required.
Experience with medical billing, CPT, ICD-10 codes, and revenue cycle processes.
One or more years of billing and coding experience in the medical field required.
Knowledge of medical terminology, anatomy, and healthcare regulations.
Ability to exercise discretion with sensitive and confidential matters.
Ability to communicate effectively by phone, in writing, and via email.
Computer skills with data entry software, Microsoft Word, and Excel.
Experience in insurance, banking, hospital, medical office, or another customer-service-heavy environment preferred.
Bilingual preferred.
Institutional accreditation and degree obtainment will be verified upon hire.
Location
Texas, US
Employment Type
Not specified
Experience Level
Associate
Remote work allowed
No
Posted
4 weeks ago