Billing and Coding Coordinator

About the Role

The Billing and Coding Coordinator is responsible for posting charges to patient accounts, preparing, verifying, and submitting electronic and paper claims to third-party payers. This role functions highly with conducting coding reviews to ensure compliance with billing regulations, verifying documentation accuracy, and collaborating with providers to resolve coding discrepancies. Additionally, the Billing and Coding Coordinator will research incomplete, incorrect, or outstanding claims and manage claim resubmissions, with a thorough understanding of all insurance plans and contractual arrangements affecting payments.

Responsibilities

• Submit clean electronic and paper claims to payers.
• Conduct coding reviews to ensure compliant CPT, ICD-10 and HCPCS coding in alignment with payer guidelines and regulatory requirements.
• Audit Software Oversight - Auditing claims with audit software to identify trends, discrepancies, and opportunities for revenue optimization.
• Identify and correct coding errors prior to claim submission to reduce denials, errors and rejections.
• Investigate and resolve claims submission problems with third-party payers and review new and existing third-party claims processing information.
• Analyze and respond to claim denials related to coding and documentation issues, working with providers and clinical staff to obtain necessary corrections.
• Review, adjust, and edit insurance coverage, bills, and statements to ensure accuracy.
• Stay up to date with coding and billing regulation changes to maintain compliance with CMS and commercial payer guidelines.
• Take phone calls from internal and external customers, answering questions, taking payments, and resolving billing and coding-related issues.
• Assist in training and educating providers and staff on coding and documentation best practices.
• Maintain accurate records of billing and coding activities, including tracking and reporting trends in claim denials and rejections.
• Other duties as assigned by management.

Qualifications

• High school diploma or equivalent required. Associate degree preferred.
• Two years progressively responsible clerical experience in a healthcare setting required.
• Experience with payer portals, clearinghouses or other healthcare systems preferred.
• Experience with Microsoft Office Suite required.
• Certified Professional Coder (CPC) preferred.

Pay

Hourly Compensation: $18.00 - $20.00 Depending on Experience

Benefits

• Medical, dental, fertility, retirement, wellness, profit sharing and more
• Comprehensive benefits package prioritizing overall well-being and financial security