Medical Coding and Billing Specialist

Job Description

Job Description

Qualifications :

Medical Billing and Coding Experience in a Primary Care setting

Knowledge of CPT-II and ICD-10 coding

Experience with Athenahealth

Strong communication and interpersonal skills

Detail-oriented

Entrepreneurial

Key Responsibilities :

• Prepare and submit billing data and medical claims to insurance companies.
• Ensure the patient’s medical information is accurate and up to date.
• Prepare bills and invoices, and documents amounts due for medical service.
• Work closely with office management on Accounts Receivable goals.
• Monitor and record late or held payments.
• Follow up on missed payments; resolve financial discrepancies.
• Examine patient bills for accuracy and request any missing information.
• Analyzes medical record documentation to determine the principal diagnosis and procedures and the presence of co-morbid or complicating conditions associated with the primary care visit.
• Assigns ICD9 and CPT2 codes to diagnoses and procedures according to established guidelines.
• Assure accurate, optimal coding assignment for reimbursement.
• Monitor the accuracy and consistency of coded clinical data by conducting ongoing internal coding audits of data, medical records, and computerized databases.
• Identify and defines coding issues and proposes solutions.
• Provide technical expertise to clinical and non-clinical staff to identify and resolve coding and medical record / chart documentation problems impacting the accuracy and consistency of coded data in the clinical database.
• Other special projects as assigned.