Responsible for accurately translating medical diagnoses, procedures, and services from physician notes into standardized codes such as ICD-10 and CPT for insurance billing and reimbursement.
Reviews medical records and patient information to ensure accurate billing, verifies insurance coverage, processes claims, resolves claim denials, and communicates with providers to clarify documentation and billing issues.
Maintains compliance with coding guidelines, reimbursement regulations, HIPAA, and state and federal requirements while supporting timely and accurate charge entry and posting.
Requirements & Qualifications
Qualifications
- Certified Professional Coder (CPC) certification required
- In-person position
- Maintain coding certification and complete yearly CEUs
- Proficiency in ICD-9 and ICD-10 coding systems
- Previous experience in medical billing or coding required
- Appeals experience preferred
- Familiarity with DRG coding preferred
- Strong computer skills, including EMR software, Excel, Word, and Outlook
- Excellent customer service and professionally written communication skills
- Strong research, organizational, and multitasking skills
- Detail-oriented with the ability to work independently and prioritize tasks effectively
Duties and Responsibilities
- Review and analyze medical records and patient information for accurate billing
- Verify patient insurance coverage and process claims for reimbursement
- Communicate with healthcare providers to resolve billing discrepancies or issues
- Maintain current knowledge of coding guidelines and regulations
- Collaborate with billing team members to ensure timely and accurate billing
- Review office visit, surgical, and non-surgical documentation for accuracy
- Ensure proper coding on provider documentation
- Verify codes are current and active
- Report missing or incomplete documentation to providers and clinical staff
- Meet daily coding production expectations
- Perform accurate charge entries
- Apply coding and reimbursement regulations to maximize reimbursement
- Monitor, update, and change fee schedules as needed
- Apply NCCI edits and global guidelines when posting services
- Serve as a resource for insurance resolutions and coding questions
- Communicate coding requirement updates to supervisor
- Post daily charges and correct posting errors in the practice management system
- Assist with internal and external audits as requested
- Review and correct missing encounter reports
- Audit charges from hospitals and surgical centers to capture all charges for posting
- Complete annual education courses as required
- Follow HIPAA and all applicable regulations
- Perform other related duties as assigned
Location
Indiana, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago
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