Billing And Coding Specialist

Job Summary:

The Medical Billing and Coding Specialist will be responsible for supporting accurate, timely

billing and coding processes within a plastics and cosmetic surgery setting. This role is also

responsible for complete, compliant, and efficient handling of patient accounts. The ideal

candidate demonstrates strong knowledge of surgical billing procedures, understanding of CPT,

ICD-10, other relevant coding systems, insurance billing procedures and regulations, high level of

detail accuracy, communication with insurance companies, patients, providers, and the ability to

work independently in a fast-paced clinical environment.

Key Responsibilities:

Verify and maintain accurate patient records, including addresses, phone numbers, and insurance details

Perform billing duties, including reviewing and verifying patient account data, and ensuring compliance with insurance requirements

Follow up on outstanding account balances with insurance companies and patients

Resolve routine billing inquiries and assist patients with account related questions

Enter charges, payments, denials, and adjustments related to patient accounts

File charges for primary and secondary insurance coverage and manage credit balances

Assist with payment posting, EOB scanning, document retrieval, and other departmental support tasks

Collaborate with coding, registration, and billing teams to support seamless workflow

Participate in training of new team members and support special projects as assigned by supervisor

Track claim status, follow up on denied or unpaid claims, and initiate appeals as needed.

Communicate effectively with patients and insurance companies regarding billing and coding issues.

Qualifications:

Minimum 3 years of billing and coding experience in a plastics and cosmetic surgery setting preferred.

Strong familiarity with surgical coding (CPT, ICD-10) specific to cosmetic and plastic procedures

Experience with pre-authorizations and insurance verification for elective and medically necessary surgeries

Proficiency in using electronic health records (EHR) and medical billing software (e.g., Epic, eClinicalWorks, AthenaHealth, or similar systems)

Comfortable navigating insurance portals and billing systems for claim follow-up and verification

Strong understanding of billing regulations, payer specific requirements, and coding compliance guidelines

Ability to identify and resolve potential coding or billing errors to reduce denials and delays in payment

Excellent attention to detail and analytical thinking

Strong organizational skills with the ability to manage multiple tasks simultaneously in a high-volume environment

Effective verbal and written communication skills for patient and insurance interactions

Positive, team-oriented attitude and professional demeanor

Ability to work independently and adapt to changing priorities with minimal supervision

Education:

High School Diploma or equivalent required