Medical Billing and Coding

• Ensure 100% charge capture by reviewing physician dictated notes and operative reports and properly code all services performed utilizing appropriate CPT, ICD-10-CM codes and modifiers.
• Daily review of EPIC Charge Review Work queues is essential.
• Monitor and report on accounts receivable issues related to payer compliance and/or billing processes.
• Act as a resource to providers, office staff, administration and the Central Business Office.
• Participation in coding training and education is also required.
• Maintain yearly certification as a Certified Professional Coder is required with the American Academy of Professional Coders.

Senior Billing Liaison, Coder

• Ability to comprehend medical record documentation to accurately assign codes for both concurrent and discharged accounts across multiple specialties.
• Meets minimum requirements for production and quality monthly.
• Requires a working knowledge of code sequencing for grouper-related payers with attention to detail to avoid rework and waste with charge capture assessment component.
• Requires understanding and application of M.E.A.T. criteria (i.e., monitoring, evaluation, assessment, treatment) using ICD 10 CM transaction data set to capture diagnoses.
• Analyzes high-risk encounters for accurate and/or missing charges gaps prior to encounter completion (i.e., missing charges from anesthesia, surgery) when manual charge capture occurs.
• Understand complexity of billing requirements and incorporates payer specific trends into day-to-day reviews to reduce “take backs” associated with unclear, or unsubstantiated care rendered. (i.e., varying modifier assignment for EAPG vs. Non-EAPG payer specificity)
• Requires excellent coding knowledge of ICD 10 CM, CPT 4, and modifier application, with expectations to maintain certification (i.e., CCS, CPC, RHIT, or RHIA) and apply ICD 10 CM Coding Guidelines specific to both inpatient and outpatient encounters.
• Facilitate modifications to clinical documentation through query interaction to ensure that the information captured supports the level of service rendered, with attention towards chronic conditions, hierarchical condition categories (HCC), and risk adjustment factors (RAF).
• Demonstrates an excellent working knowledge of hospital information systems to retrieve data specific information (i.e., order diagnosis, patient type) within a complicated filing schema including non-hospital data (i.e., Media Tab, Office Visits etc)

Outpatient Surgery Coder

• Reviewing documentation and selecting the appropriate procedure and/or diagnosis code to be entered in billing documents
• Ensuring that teaching physician requirements are met and clearly reflected in the documentation
• Other duties as assigned

Certified Coder – Practice Operations, Certified Professional Coder certification required

• Reviewing documentation and selecting the appropriate procedure and/or diagnosis code for billing documents
• Ensuring teaching physician requirements are met and clearly reflected in the documentation
• Other duties as assigned

Certified Coder – Part-Time

• 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

• Ensure the accuracy of charges and diagnoses selected by Meritus Health practitioners
• Review provider documentation and assign appropriate ICD‑10‑CM , CPT , and E&M codes
• Serve as a coding resource and liaison for assigned physician practices
• Deliver provider/practitioner education as needed
• Ensure adherence to Official Coding Guidelines , CPT Assistant , and organizational standards
• Maintain confidentiality and uphold high professional and ethical standards

Professional Coder – Billing Charge Verifier

• Performs HCC coding on projects for MA, ACA, and End Stage Renal Disease (ESRD)
• Works independently in various coding applications
• Adheres to CMS Guidelines for Coding and Highmark’s Policy and Procedures
• Maintains RPM coding accuracy and productivity requirements
• Assists with Regulatory Audits by performing first coding review

HCC Coding Specialist

• Reviewing documentation and selecting appropriate procedure and/or diagnosis code for billing documents
• Ensures teaching physician requirements are met and reflected in the documentation
• Review provider coding and provide training and feedback on coding questions and issues
• Assist billing and collections staff with denials and charge correction requests as needed
• Resolves coding TES edits and refreshes knowledge of government regulations related to coding and billing

Certified Coder – Medicine

• Accurately assigns diagnosis and procedure codes for inpatient facility and professional services.
• Performs necessary tasks within MHS GENESIS and other military coding systems.
• Accurately assign Evaluation and Management (E&M) codes, ICD-CM diagnoses, CPT and HCPCS, modifiers, and quantities derived from medical record documentation.
• Reviews encounter and/or record documentation to identify and resolve inconsistencies, ambiguities, or discrepancies.
• Assigns accurate codes based on provider responses to coding queries.
• Supports DHA coding compliance by performing due diligence in ethically and appropriately researching and/or interpreting existing guidance.
• Utilizes MHS computer systems to remotely access patient records and assign codes for patient encounters in support of other MTFs.
• Achieve and maintain DHA coding productivity and accuracy standards for the position.
• Educates and provides feedback to providers and clinical staff to resolve documentation issues to support coding compliance.
• Acts as a source of reference to medical staff having questions, issues, or concerns related to coding.
• Responds to provider questions and provides examples of appropriate coding and documentation reference(s).

Medical Coder II

• Review clinical documentation and assign accurate codes using ICD-10-CM, ICD-10-PCS, and CPT systems
• Abstract key data elements for reporting to CMS, HSCRC, and other regulatory agencies
• Code outpatient and recurring accounts across multiple service lines, including JMC-JMC/R, BHS, and Outpatient Rehab
• Ensure coding quality supports internal and external reporting, billing, and analytics

Outpatient Ancillary Coding Specialist

• Reviews documentation and assigns appropriate ICD-10, CPT and HCPCS codes.
• Assigns appropriate primary diagnosis after deciding what was chiefly responsible for the encounter.
• Assigns appropriate modifiers according to guidelines.
• Finalizes the appropriate data for accounts.
• Clarifies documentation or diagnosis by communicating with the physician.
• Ensures weekly, monthly, and quarterly department goals are met.
• Makes recommendations to the Billing and Coding Manager for process and quality improvement.
• Maintains knowledge of current coding rules and trends for coding types assigned by attending seminars, workshops and watching webinars.

Medical Coder

• Reviewing documentation and selecting the appropriate procedure and/or diagnosis code to be entered in billing documents
• Ensuring that teaching physician requirements are met and are clearly reflected in the documentation
• Other duties as assigned

Certified Coder – Practice Operations, Certified Professional Coder

• Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. ( 65%)
• Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. ( 15%)
• Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. ( 10%)
• Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources and implementing these updates in daily work. ( 5%)
• Performs other duties as assigned or required. (5%)

Coder – Outpatient

• Responsible for accurate and timely assignment of ICD 10 CM/PCS and HCPCS/CPT codes.
• Payment group classification assignment and data abstraction for reimbursement purposes.
• Reviews and interprets Inpatient, Outpatient, Ancillary, Diagnostics and Emergency Medicine records.
• Performs coding and abstracting tasks to support data quality and statistics.
• Utilizes information on diagnostic reports to accurately code patient charts.
• Works within service line structure based on patient type.
• Provides all necessary coded and abstracted information required for final coding and billing.

Coder III

• Identify opportunities to improve provider documentation and create an education plan tailored to each assigned provider
• Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements
• Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques
• Provider onsite education, based on business needs
• Collaboration with other market provider facing role
• Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards
• Analyze coding audit results and other relevant data to develop data-driven educational materials and interventions
• Participate in cross-functional teams to improve documentation, data integrity, and workflow processes

Medical Billing and Coding jobs in Maryland

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Senior Billing Liaison, Coder

Outpatient Surgery Coder

Certified Coder – Practice Operations, Certified Professional Coder certification required

Certified Coder – Part-Time

Medical Billing Specialist

Professional Coder – Billing Charge Verifier

HCC Coding Specialist

Certified Coder – Medicine

Medical Coder II

Outpatient Ancillary Coding Specialist

Medical Coder

Certified Coder – Practice Operations, Certified Professional Coder

Coder – Outpatient

Coder III

Medical Coder