Medical Coding Auditor, Outpatient
BASF
Medical Hospital Billing and AR Specialist
Trajectory Revenue Cycle Services
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteJob Level
JuniorMid-Level
About the role
- Billing & Claims Processing: Prepare, review, and submit accurate insurance and patient claims for ASC and OBL cardiology procedures
- Verify coding accuracy (ICD-10, CPT, HCPCS, modifiers) for compliance and reimbursement optimization
- Ensure proper claim submission through clearinghouses and payer portals
- Accounts Receivable Management: Monitor and manage aging reports; follow up on unpaid or underpaid claims
- Resolve claim denials and appeals by researching payer guidelines and submitting corrected claims
- Post payments, adjustments, and denials in practice management systems accurately
- Communicate with insurance companies to expedite claim processing and collections
- Patient Account Support: Handle patient billing inquiries professionally and provide accurate account information
- Coordinate payment plans and process patient payments as needed
- Compliance & Reporting: Ensure compliance with all federal, state, and payer-specific billing regulations
- Maintain up-to-date knowledge of ASC and OBL cardiology reimbursement policies
- Generate and analyze billing and A/R reports to identify trends and recommend improvements
Requirements
- 2+ years of medical billing/accounts receivable experience (preferably cardiology, ASC, or OBL)
- Strong understanding of CPT/ICD-10 coding, medical terminology, and payer reimbursement guidelines
- Experience with electronic health records (EHR), practice management, and clearinghouse systems
- Knowledge of Medicare, Medicaid, and commercial insurance billing requirements
- Excellent organizational skills with strong attention to detail
- Ability to work independently and manage workload remotely
- Preferred: Certified Professional Coder (CPC), Certified Professional Biller (CPB), or equivalent certification
- Prior cardiology ASC/OBL billing experience
- Familiarity with prior authorizations, appeals, and revenue cycle KPIs
- Skills & Competencies: Strong written and verbal communication skills
- Problem-solving and critical thinking in resolving claim/payment issues
- Ability to prioritize tasks and meet deadlines in a remote work setting
- Professional, dependable, and confidential handling of sensitive information
