Join our dynamic healthcare team as a Certified Medical Coder/Biller, where your expertise will directly impact the accuracy and efficiency of medical billing and coding processes. In this vital role, you will ensure that healthcare providers' documentation aligns with industry standards, facilitating smooth reimbursement workflows. Your attention to detail and knowledge of medical coding systems will help optimize revenue cycle management while maintaining compliance with regulatory requirements.
Duties
- Accurately assign diagnosis codes using ICD-9, ICD-10, and ICD coding systems to ensure precise patient records.
- Review and process prior authorization requests for medical services, procedures, and medications.
- Utilize CPT (Current Procedural Terminology) codes for documenting procedures and services provided during patient visits.
- Review medical records and documentation to verify completeness and correctness before billing submissions.
- Prepare and submit clean claims through Electronic Medical Record (EMR) or Electronic Health Record (EHR) systems, ensuring timely processing.
- Manage medical billing processes, including follow-up on unpaid claims and resubmissions for denied or rejected claims.
- Collaborate with healthcare providers to clarify documentation discrepancies and improve coding accuracy.
- Conduct medical collections activities when necessary, following appropriate protocols to recover outstanding balances.
Requirements & Qualifications
- Proven experience in medical billing and coding within a healthcare setting, with familiarity in handling diverse medical specialties.
- Strong knowledge of DRG (Diagnosis-Related Group) classifications and their application in billing processes.
- Proficiency in using EMR/EHR systems for documentation, coding, and billing purposes.
- Familiarity with medical terminology, medical records management, and the principles of accurate medical coding practices.
- Experience working with ICD-9, ICD-10, CPT coding standards, and understanding their updates and changes over time.
- Ability to interpret complex medical documentation accurately to assign appropriate codes efficiently.
- Familiarity with various healthcare systems and software used for processing authorizations.
- Strong attention to detail with excellent organizational skills to manage multiple requests efficiently.
- Effective communication skills for liaising between patients, providers, and insurance representatives.
- Ability to work independently while also being a collaborative team member in a fast-paced environment.
- Prior exposure to medical collection procedures and insurance claim processes is a valuable asset.
Benefits & Perks
- Dental insurance
- Flexible schedule
- Health insurance
- Paid time off
- Vision insurance
Location
Utah, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago