Medical Billing & Coding Specialist

Job Description

Specialized Medical Billing is looking for a Fulltime Certified Medical Biller or Certified Coder, (CPC, CMC, or CCS) to join our team our team, MUST be located in the state of OHIO. Out of state applicants will not be considered. Not a remote position.

This is an in-office position and out of state resumes will not be reviewed!

No Weekends or evenings as a part of your regular shift. Flexible schedule available.

Complete benefits package available, including health, dental, vision, and Paid Time Off after initial employment period.

Job Requirements

Review and enter charges accurately.

Submit insurance claims electronically and via paper when necessary.

Follow up on unpaid claims in a timely manner.

Identify and correct claim errors.

Post payments and reconcile accounts.

Communicate with insurance companies, providers, and patients about billing issues.

Maintain organized, accurate billing records.

Strong attention to detail and accuracy.

Ability to work independently and meet deadlines.

Good written and verbal communication skills.

Problem-solving skills for resolving claim rejections and denials.

Ability to maintain confidentiality and professionalism.

Organizational skills for managing high volumes of claims.

Additional Expectations

Ability to work in fast-paced environments with changing payer regulations.

Willingness to stay updated on billing and coding guidelines through continuing education.

Some positions may require knowledge of specialty-specific billing (e.g., ENT, Nephrology, Pain Management, Wound Care, Behavioral Health).

Review medical records and operative reports to accurately assign a procedure (CPT) and diagnosis (ICD-10) code to the service

Able to ascertain the highest level of CPT to bill the charge and ensure within coding guidelines

Charge data must be entered within 24 hours -48 hours upon receipt of the authenticated and complete documentation

Weekly review and subsequent communication with office managers and physicians regarding any outstanding items required to code and enter a charge

Work closely with the office liaison to determine if there are any missing charges and all services are entered by month-end

Append modifiers based on insurance carrier specific coding policies

Code services based on the Correct Coding Initiative (CCI) to make sure bundled charges are not billed

Re-code charges that were incorrectly coded the first time or were denied by the insurance carrier

Review physician dictation making sure note/report is thorough and sufficient for coding a service. If not, the CPC will bring this to the attention of the manager.

Review emails in Outlook and in the EMR system multiple times throughout the day

Respond timely to all communications received from physicians, office managers and staff regarding coding questions and concerns

Audit medical charts to determine charges were billed within compliance of federal coding regulations and maximum revenue collected (under-coded/up coded)

Proactively look for trends in billing errors to optimize coding processes

Always follow HIPAA guidelines and safeguard medical records for patient confidentiality

Pay: $16.00 - $20.00 per hour

Job Types: Full-time, Part-time

Benefits:

Health insurance

Life insurance

Paid time off

Work Location: In person

Full-time