Medical Billing and Coding

• Coordinate/review the work of subordinate employees and assist with the training and continuing education programs.
• Code medical records utilizing ICD-10-CM and CPT-4 coding conventions.
• Review the medical record to ensure specificity of diagnoses, procedures, and appropriate/optimal reimbursement for hospital and/or professional charges.
• Abstract information from medical records following established methods and procedures.
• Review the complex (problematic coding that needs research and reference checking) medical records and accurately code the primary/secondary diagnoses and procedures using ICD-10-CM and/or CPT coding conventions.
• Ensure quality and quantity of work performed through regular audits.
• Assist with research, development, and presentation of continuing education programs in areas of specialization.
• Sequence the diagnoses and procedures using coding guidelines.
• Ensure DRG/APC assignment is accurate.
• Abstract and compile data from medical records for appropriate optimal reimbursement for hospital and/or professional charges.
• Consult with and educate physicians on coding practices and conventions in order to provide detailed coding information.
• Communicate with nursing and ancillary services personnel for needed documentation for accurate coding.
• Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes, and surgical techniques through participation in continuing education programs to effectively apply ICD-10-CM and CPT-4 coding guidelines to inpatient and outpatient diagnoses and procedures.
• Maintain a thorough understanding of medical record practices, standards, regulations, Joint Commission on Accreditation of Health Organizations (JCAHO), Health Care/Finance Administration (HCFA), Medical Review of North Carolina (MRNC), etc.
• Assist with special projects as required.
• Perform other related duties incidental to the work described herein.

Medical Records Coder II – Ophthalmology

• Responsible for maintaining the professional reimbursement program.
• Ensure compliance with current payments and rules that impact billing and collection.
• Performs billing and computer functions, including patient & third party billing, data entry and posting encounters.
• Follow-up of any outstanding A/R all-payers, self-pay, and the resolution of denials.
• Prepares and submits clean claims to various insurance companies either electronically or by paper.
• Handle the follow-up of outstanding A/R all-payers, including self-pay and /or the resolution of denials.
• Answers question from patients, FHCHC staff and insurance companies.
• Identifies and resolves patient billing complaints.
• Prepares reviews and send patient statements and manage correspondence.
• Handle all correspondence related to insurance or patient account, contacting insurance carriers, patients and other facilities as needed to get the maximum payments and accounts and identify issues or changes to achieve client profitability.
• Take call from patients and insurance companies regarding billing and statement questions.
• Process and post all patient and/or insurance payments.
• Reviewing clinical documentation and provide coding support to clinical staff as needed.

Medical Billing Coder

• The Surgical Coder for Spine is responsible for accurate and compliant coding of complex orthopedic spine procedures across all care settings.
• Code high-complexity spine procedures (e.g., fusions, decompressions, instrumentation, revisions).
• Verify all documentation is complete and compliant.
• Assign codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines.
• Follow coding conventions and ensure accurate assignment of CPT (including add-on codes, modifiers, bundling rules).
• Validate levels, laterality, approach (anterior/posterior).
• Identify missed billable components (e.g., additional levels, hardware, biologics).
• Query provider for any necessary clarification related to unclear, unspecified or missing/incomplete documentation.
• Apply payer-specific coding rules and edits.
• Research, analyze, recommend, and facilitate a plan of action to correct discrepancies and prevent future coding errors.

Surgical Coder – Spine Specialty

• Prepare, review, and submit clean medical claims to commercial payers.
• Verify claim accuracy, including coding, modifiers, eligibility, EAP authorizations, and provider details
• Monitor claim rejections and take timely corrective actions
• Manage denial resolution: research root cause, correct and resubmit, or prepare appeals
• Conduct proactive follow-up on outstanding A/R and aging claims
• Support patient billing activities and inquiries when needed
• Document all billing activities clearly and accurately in internal systems
• Ensure compliance with HIPAA, payer regulations, and state/federal billing guidelines
• Collaborate with credentialing, eligibility/benefits, clinical operations, and internal RCM teammates
• Identify trends and recommend process improvements to reduce denials and rework

Medical Billing Specialist

• Coordinate/review the work of subordinate employees and assist with the training and continuing education programs.
• Code medical records utilizing ICD-10-CM and CPT-4 coding conventions.
• Review the medical record to assure specificity of diagnoses, procedures, and appropriate/optimal reimbursement for hospital and/or professional charges.
• Abstract information from medical records following established methods and procedures.
• Review the complex medical records and accurately code the primary/secondary diagnoses and procedures using ICD-10-CM and/or CPT coding conventions.
• Ensure quality and quantity of work performed through regular audits.
• Assist with research, development, and presentation of continuing education programs on areas of specialization.
• Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes, and surgical techniques through participation in continuing education programs.

Medical Billing and Coding jobs in Connecticut

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Medical Records Coder II – Ophthalmology

Medical Billing Coder

Surgical Coder – Spine Specialty

Medical Billing Specialist

Medical Records Coder II – Outpatient