Medical Billing and Coding

• 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

• Review medical documentation from physicians and other healthcare providers
• Assign modifiers, diagnostic and procedure codes for symptoms, diseases, injuries, surgeries and treatments according to official classification systems and standards
• Provide accurate and timely ICD-10-CM coding of diagnoses, HCPCS and CPT coding
• Review and audit medical record documentation accurately to reflect healthcare coding and substantiate appropriate service reimbursement
• Convey coding guidelines to physicians and other healthcare providers to improve the accuracy of medical record documentation
• Participate in coding team meetings and serve as a subject matter expert.

Coder, Provider Practice – Hospitalist

• Process claims to appropriate primary, secondary, and/or tertiary insurance company according to insurance guidelines
• Perform follow-up on unpaid insurance accounts identified through aging reports
• Process appeals when appropriate
• Process refund requests
• Identify trends, and carrier issues relating to billing and reimbursements, report findings to leadership
• Maintain Privacy & Confidentiality of patient information and organizational operations
• Responsible for learning, understanding and following payer guidelines
• Reallocate misapplied payments and adjustments
• Work special assignments when needed

Medical Billing & Collections Specialist

• Read and analyze patient records
• Accurately and efficiently code for various services including evaluation and management, laboratory, imaging, injections and infusions, and specialty surgical procedures
• Monitor, research, and correct claim denials within health plan requirements
• Submits clean claims for payment
• Complies with Federal and State standards utilizing CCI edits and bulletins
• Maintain knowledge of and comply with coding guidelines
• Interacts with clients to ensure accuracy

Medical Coder II

• Read and analyze patient records
• Accurately and efficiently code for a variety of services including but not limited to, evaluation and management, laboratory, imaging, injections and infusions, and specialty surgical procedures in the clinic and hospital outpatient settings
• Monitor, research, and correct claim denials within health plan requirements and document any trends with which to follow-up
• Submits clean claims for payment
• Complies with Federal and State standards utilizing CCI edits, Medicare bulletins, ACR bulletins, etc. to keep abreast of the changes within the industry
• Maintains knowledge of and complies with coding guidelines
• Find documentation in multiple EMR systems such as EPIC, ECW, Cerner, Meditech
• Interacts with clients to ensure accuracy
• Maintain patient confidentiality and information security
• Maintain an error rate of 5% or less
• Must meet production goals assigned by supervisor

• Review medical documentation and assign appropriate codes (ICD-10, HCPCS, CPT).
• Ensure compliance with coding standards, regulations, and company procedures.
• Communicate effectively with medical professionals to improve documentation accuracy.
• Participate in coding team meetings and serve as a subject matter expert.
• Validate physician charge capture and conduct appeals management related to coding.

Coder, Provider Practice

• Review medical documentation and assign appropriate codes (ICD-10, HCPCS, CPT).
• Ensure compliance with coding standards, regulations, and company procedures.
• Communicate effectively with medical professionals.
• Participate in coding team meetings and serve as a subject matter expert.
• Validate physician charge capture and assist with the appeal process.

Coder, Behavioral Health

• Perform coding and related duties using established billing office policies in an accurate and timely manner.
• Primary contact with physicians, department administrators, hospital and/or clinical department administrators and their support staff and billing staff.
• Coordinates professional service billings for selected clinical departments.
• Assignment or verification of CPT, ICD-10 CM coding and modifiers based upon documentation.
• Resolve edits for electronic charges, following established policies and procedures to ensure that all data elements are applied.
• Monitor charge flow and act as a liaison with managers, department administrators and other billing personnel.
• Identify, report, and resolve coding and reimbursement issues.

Coding Specialist II – Radiation Oncology

• Perform coding and related duties using established billing office policies in an accurate and timely manner.
• Primary contact with physicians, department administrators, hospital and/or clinical department administrators and their support staff and billing staff.
• Coordinates professional service billings for selected clinical departments.
• Assignment or verification of CPT, ICD-10 CM coding and modifiers based upon documentation.
• Resolve edits for electronic charges, following established policies and procedures to ensure that all data elements (claim requirements – CPT, ICD-10 CM, modifiers, provider, billing area, etc.) are applied.
• Monitor charge flow and act as a liaison with managers, department administrators and other billing personnel to assure consistent and accurate change flow.
• Identify, report, and resolve coding and reimbursement issues.
• Develop and maintain all protocols related to their assigned areas.
• Maintain understanding all Teaching Physician and provider documentation policies.
• Actively participate in new provider orientations.

Coding Specialist II – Psychiatry

• Evaluate medical records and provide clinical and surgical abstraction
• Accurately code diagnostic and procedural information
• Consult with medical providers for record clarification
• Ensure compliance with coding rules and regulations
• Compile reports and tabulate data from medical records
• Identify validation edits and ensure accurate coding
• Work independently under regular supervision

See all jobs on JobTailor

Medical Coder

Coder, Provider Practice – Hospitalist

Medical Billing & Collections Specialist

Medical Coder II

Medical Coder II

Coder, Provider Practice

Coder, Behavioral Health

Coding Specialist II – Radiation Oncology

Coding Specialist II – Psychiatry

Complex Coder, Surgical Cardiology