Job Summary :
The Medical Billing and Coding Specialist will be responsible for supporting accurate, timely
billing and coding processes within a plastics and cosmetic surgery setting. This role is also
responsible for complete, compliant, and efficient handling of patient accounts. The ideal
candidate demonstrates strong knowledge of surgical billing procedures, understanding of CPT,
ICD-10, other relevant coding systems, insurance billing procedures and regulations, high level of
detail accuracy, communication with insurance companies, patients, providers, and the ability to
work independently in a fast-paced clinical environment.
Key Responsibilities :
- Verify and maintain accurate patient records, including addresses, phone numbers, and insurance details
- Perform billing duties, including reviewing and verifying patient account data, and ensuring compliance with insurance requirements
- Follow up on outstanding account balances with insurance companies and patients
- Resolve routine billing inquiries and assist patients with account related questions
- Enter charges, payments, denials, and adjustments related to patient accounts
- File charges for primary and secondary insurance coverage and manage credit balances
- Assist with payment posting, EOB scanning, document retrieval, and other departmental support tasks
- Collaborate with coding, registration, and billing teams to support seamless workflow
- Participate in training of new team members and support special projects as assigned by supervisor
- Track claim status, follow up on denied or unpaid claims, and initiate appeals as needed.
- Communicate effectively with patients and insurance companies regarding billing and coding issues.
Qualifications :
Minimum 3 years of billing and coding experience in a plastics and cosmetic surgery setting preferred.Strong familiarity with surgical coding (CPT, ICD-10) specific to cosmetic and plastic proceduresExperience with pre-authorizations and insurance verification for elective and medically necessary surgeriesProficiency in using electronic health records (EHR) and medical billing software (e.g., Epic, eClinicalWorks, AthenaHealth, or similar systems)Comfortable navigating insurance portals and billing systems for claim follow-up and verificationStrong understanding of billing regulations, payer specific requirements, and coding compliance guidelinesAbility to identify and resolve potential coding or billing errors to reduce denials and delays in paymentExcellent attention to detail and analytical thinkingStrong organizational skills with the ability to manage multiple tasks simultaneously in a high-volume environmentEffective verbal and written communication skills for patient and insurance interactionsPositive, team-oriented attitude and professional demeanorAbility to work independently and adapt to changing priorities with minimal supervisionEducation :
High School Diploma or equivalent requiredEqual Opportunity Employer / Protected Veterans / Individuals with Disabilities
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