Medical Billing and Coding

• Responsible for reviewing clinical documentation and accurately assigning CPT, ICD-10, and HCPCS codes and modifiers for orthopedic procedures, services, and diagnoses.
• Ensures proper billing and compliance with regulatory requirements.
• Collaborate with orthopedic providers to clarify documentation and ensure complete, accurate coding.
• Audit and verify codes for accuracy prior to claim submission to reduce denials and improve revenue cycle performance.
• Monitor and stay current with updates to coding guidelines and payer rules.

Certified Professional Coder – Orthopedics

• Analyze and interpret complex records in order to identify and accurately bill for services with the appropriate ICD-10 and CPT/HCPCS codes.
• Assigning/sequencing billing codes in compliance with third party payor requirements and obtaining clarification when presented with conflicting or non-specific documentation, when necessary.
• Involved in reviewing coding-related denials from payors and making recommendations to resolve claims based on payer guidelines.

Multi-Specialty Medical Coder

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Lead Medical Billing Specialist

• Manage the accounts receivable for timely and maximum reimbursement by adhering to company billing and collection policies.
• Review coding & charges, ensure the completion of team members daily task.
• Follow-up with external and internal customers to ensure remediation of customer issues.
• Communicate with the AR Manager concerning central billing issues, questions, concerns, corrective actions or training needs.
• Perform daily, monthly and special system processing requirements (i.e. batch posting and balancing).

• Ensure accurate and appropriate gathering of information into the coding classification systems
• Responsible for obtaining accurate and complete documentation in the medical record for accurate coding assignment
• Responsible for the coding of moderately complex patient classes i.e. ED, observations, same day care, etc.
• Reviews and accurately interprets medical record documentation from all hospital accounts
• Assigns hospital codes to a variety of patient classes (i.e. ED, OBS, SDC, etc.)
• Assures quality and timely coding, charging and abstraction of accounts for assigned specialty areas
• Contacts physicians or any persons necessary to obtain information required for accurate code assignments

Inpatient Hospital Coding Specialist II

• Codes inpatient and/or IRAD 90% of current FTE status.
• Reviews and accurately interprets medical record documentation from all hospital accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10-CM, ICD-10-PCS, CPT, or modifier codes for each diagnosis and procedure that is identified (inpatient and IRAD).
• Ensures appropriate MS-DRG assignment based on accurate ICD-10-CM and ICD-10-PCS coding assignment and medical record documentation.
• Assigns hospital codes to a variety of patient classes (i.e. I/P, IRAD, etc.).
• Assures that quality and timely coding, charging and abstraction of accounts are completed daily for assigned specialty areas.
• Maintains and enhances current levels of coding knowledge through quality review, attendance and participation at clinical in-services and coding seminars, internal meetings, study of circulating reference materials, and inclusion of updates to coding manuals.
• Assures the accuracy, quality, and timely review of data needed to obtain a clean bill.
• Contacts physicians or any persons necessary to obtain information required for to accurately code assignments. Works and communicates with other offices in any manner necessary to facilitate the billing process.

Inpatient Hospital Coding Specialist, Level III

• Responsible for coding procedures and entering charges to comply with federal/state regulations and internal policies
• Coordinate with Practice Coordinator and Revenue Integrity to assure all necessary documentation is present to support selected procedure codes or to code cases as needed
• Participates in audits to evaluate if all selected codes are accurate and develops methodologies to improved coding issues identified

Practice Coding Specialist

• Review and abstract professional medical records, including provider notes, encounters, and supporting documentation.
• Assign ICD-10-CM, CPT, HCPCS, and applicable modifiers accurately, following national and payer-specific coding guidelines.
• Validate that all codes are supported by provider documentation; query providers for clarification when necessary.
• Maintain coding quality metrics (accuracy, productivity, and compliance) as defined by leadership.
• Participate in internal and external coding audits; provide feedback to improve documentation and coding processes.
• Stay current with updates to CPT, ICD-10, HCPCS, and CMS risk adjustment guidelines.
• Maintain confidentiality and adhere to all HIPAA and compliance standards.

Medical Coder

• Accurately posting incoming payments, including checks, ACH transactions, credit card payments, and electronic remittances
• Generating and distributing patient statements, invoices, and account communications
• Reconciling payments against account balances and researching discrepancies
• Monitoring Accounts Receivable aging reports and following up on outstanding balances
• Communicating professionally with insurance carriers, patients, and client representatives regarding billing questions and payment issues
• Researching and resolving denials, underpayments, disputed charges, and billing discrepancies
• Processing account adjustments, credits, refunds, and write-offs according to established policies
• Reviewing explanation of benefits (EOBs) and remittance advice to ensure accurate reimbursement
• Maintaining detailed documentation of account activity, payment arrangements, and collection efforts
• Collaborating with providers, front office staff, clinical teams, administrative personnel, and client stakeholders to resolve account concerns
• Assisting with month-end billing and revenue cycle activities across multiple client accounts
• Maintaining accurate patient and account information within billing systems
• Supporting audit requests by providing billing documentation and account records
• Managing billing workflows for multiple healthcare clients while meeting quality and productivity expectations
• Performing other related duties as assigned

Medical Billing Specialist

• Account for coding and abstracting of patient medical appointments
• Research and analyze data needs for reimbursement
• Ensure codes are properly sequenced
• Analyze, file, and process medical records
• Keep detailed documentation of any deficiencies or issues with medical records
• Provide education and training to other coding staff
• Review and verify documentation

Medical Billing and Coding Expert

• 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 coding conventions • Review medical record documentation and accurately code the primary/secondary diagnoses using ICD-10-CM coding conventions • Sequence diagnoses using coding guidelines • Abstract and compile data from medical records for appropriate optimal reimbursement for Home Health or Hospice and/or professional charges • Consult with and educate physicians on coding practices and conventions 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 coding guidelines to inpatient and outpatient diagnoses and procedures • Maintain a thorough understanding of medical record practices, standards, regulations, The Joint Commission, Health Care/Finance Administration (HCFA), Medical Review of North Carolina (MRNC), DHHS (Department of Health and Human Service), etc. • Assist with special projects as required • Perform other related duties as assigned.

Medical Records Coder II

• 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

• Accurately assigning diagnosis and procedure codes to inpatient discharges
• Keeping abreast of new coding developments
• Possess knowledge and experience for accurate code assignment
• Coding Obstetrics, Newborn and Behavioral Health encounters when assigned
• Querying physicians for unclear documentation
• Working with Clinical Documentation Specialists for optimal DRG assignment
• Maintaining department productivity standards with 95% accuracy
• Other duties as assigned

Inpatient Coder/Abstractor – Health Information Management

• The Senior Inpatient Coder is responsible for accurately assigning diagnosis and procedure codes to inpatient discharges at the larger McLeod Health facilities representing more complex medical/surgical encounters.
• Keeps abreast of all new coding developments by attending any coding classes, reading articles on coding updates, and attending seminars when available.
• Possess inpatient coding knowledge and experience necessary to accurately assign codes to determine correct principal diagnosis, identify and assign co-morbidities and complications, secondary diagnoses, present on admission indicator, discharge disposition, Hospital Acquired conditions, principal procedure, and secondary procedures on all discharged inpatient records to arrive at the most appropriate DRG assignment.
• Understands coding guidelines to accurately apply coding principles to encounters with longer lengths of stay, complex medical diagnoses and extensive surgical procedures. This includes cardiac, neurosurgery, orthopedic, pediatric, trauma, and vascular.
• Queries physicians appropriately when documentation is not clear in the medical record.
• Works closely with the Clinical Documentation Specialists to assure the most optimal DRG is assigned.
• Maintains department specific productivity standards with a 95% accuracy rate.
• Performs other duties as assigned.

Inpatient Coder/Abstractor Sr – Health Information Management

• Prepare and submit billing data and medical claims to insurance companies
• Ensure the patient’s medical information is accurate and up to date
• Review patient statements
• Collect and review referrals and pre-authorizations
• Access EMRs to locate patient demographics and insurance information
• Call payers to obtain information regarding patient eligibility, authorization, and/or denials
• Monitor and record patient payments
• Investigate and Appeal denied claims
• Work front end rejections and back-end denials
• Help patients develop payment plans
• Other duties as assigned

AR Medical Billing Specialist

• Receive, review, and process requests for medical records from patients, healthcare providers, insurance companies, and other authorized entities
• Verify patient authorization forms and ensure legal requirements are met before releasing information
• Maintain compliance with HIPAA and other federal, state, and organizational privacy regulations
• Retrieve, scan, copy, and transmit medical records through approved methods
• Document all disclosures of protected health information in accordance with policies and procedures
• Respond to inquiries regarding medical record requests and release procedures
• Maintain accurate logs and records of requests, releases, and correspondence
• Identify and escalate complex privacy or compliance issues when necessary
• Collaborate with Health Information Management (HIM) staff, providers, and other departments
• Meet productivity, quality, and turnaround time standards

Medical Records Clerk, Coding

• Monitor Outpatient Coding work queues and unbilled accounts to support timely filing and claims submission.
• Review patient medical records to assign and sequence codes according to industry-standard coding guidelines (ICD-10-CM, CPT, HCPCS).
• Review and resolve Coding related edits (e.g., NCCI, LCD/NCD, modifier usage) to prevent first pass denials.
• Ensure coding accuracy to support correct billing and minimize claim denials or delays.
• Work closely with providers to clarify documentation and ensure coding accuracy based on organizational policy.
• Maintain up-to-date knowledge of coding guidelines, payer requirements, and regulatory changes.
• Ensure Compliance: Adhere to legal and regulatory requirements, including HIPAA, to maintain patient confidentiality and data security.
• Stay updated: Keep abreast of changes in coding standards and regulations to ensure compliance and accuracy in coding practices.
• Use electronic health records (EHR) and coding software to code services and enter data.
• Participate in coding education and training as needed.
• Follow HIPAA and confidentiality guidelines regarding patient health information.

Outpatient Coder – Provider Based, Pro-Fee and Hospital Based

• Review clinical documentation to assign and sequence diagnostic and procedural codes for Facility Inpatient records
• Validate MS-DRG calculations to accurately capture the diagnoses and procedures
• Perform documentation review and assessment for accurate abstracting of clinical data
• Maintain strict patient and provider confidentiality in compliance with HIPPA
• Participate in client and staff meetings, trainings, and conference calls as requested and/or required.

Inpatient Coder

• Coordinate annual and quarterly ICD-10, CPT, and HCPCS code updates.
• Review and analyze coding changes to determine business and operational impacts.
• Prepare code change documentation for stakeholder review.
• Collaborate with business users, stakeholders, and technical teams to implement coding and policy updates.
• Participate in meetings related to healthcare systems modernization initiatives.
• Serve as a Subject Matter Expert (SME) for medical coding methodologies and Medicaid-related processes.
• Research business rules, requirements, and workflows to develop recommendations.
• Maintain business rules, process documentation, and requirements repositories.
• Support process documentation, knowledge transfer, and training activities.
• Review medical records against established criteria to determine medical necessity when required.
• Assist with additional healthcare and project-related initiatives.

Clinical Analyst, Coding Specialist

• Provide accurate and timely revenue cycle and account management services to OBS member clients
• Identify and resolve claims issues, maintaining compliance with payer requirements
• Engage in continuous process improvement
• Provide high-quality billing and customer service support to member clinics and their patients
• Manage self-pay accounts and customer inquiries or processing daily claims production

Medical Billing and Coding jobs in United States

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Certified Professional Coder – Orthopedics

Multi-Specialty Medical Coder

Lead Medical Billing Specialist

Lead Medical Billing Specialist

Inpatient Hospital Coding Specialist II

Inpatient Hospital Coding Specialist, Level III

Practice Coding Specialist

Medical Coder

Medical Billing Specialist

Medical Billing and Coding Expert

Medical Records Coder II

Medical Records Coder II – Ophthalmology

Inpatient Coder/Abstractor – Health Information Management

Inpatient Coder/Abstractor Sr – Health Information Management

AR Medical Billing Specialist

Medical Records Clerk, Coding

Outpatient Coder – Provider Based, Pro-Fee and Hospital Based

Inpatient Coder

Clinical Analyst, Coding Specialist

Medical Billing Specialist – Self Pay