Medical Coder/Accounts Receivable Specialist

Daily Tasks

• Accurately assign appropriate ICD-10, CPT, and HCPCS codes to patient diagnoses, treatments, and procedures based on physician documentation.
• Ensure coding practices adhere to all relevant regulations, payer guidelines, and healthcare industry standards.
• Review and interpret clinical documentation to ensure proper coding of complex cases.
• Identify and correct coding errors and discrepancies to prevent claims denials and rejections.
• Collaborate with healthcare providers to clarify ambiguous or unclear documentation for accurate coding.
• Stay up to date with industry changes, including coding updates, billing regulations, and insurance requirements.

Accounts Receivable

• Maintain the AR process, ensuring timely and accurate billing and follow-up on unpaid claims.
• Review and resolve denied or rejected claims, working with insurance companies to appeal denials and secure payment.
• Post payments to patient accounts, ensuring accuracy and reconciling any discrepancies.
• Conduct regular follow-up on outstanding balances, contacting patients and insurance companies as needed to secure payment.
• Maintain detailed records of communication with insurance providers and patients for audit and reporting purposes.

Requirements

• Certification in Medical Coding (AAPC, CPC, CCS, or equivalent) required.
• 2+ years of experience in medical coding and/or AR within a healthcare setting.
• Knowledge of ICD-10, CPT, and HCPCS coding systems.
• Familiarity with healthcare billing processes and insurance claim submission requirements.
• Strong understanding of HIPAA and other relevant healthcare compliance regulations.
• Proficiency in healthcare billing software and electronic medical records (EMR) systems.
• Excellent attention to detail and accuracy in coding and financial tasks.
• Strong organizational and time management skills, with the ability to prioritize tasks and meet deadlines.
• Effective communication skills, both written and verbal, for interacting with healthcare providers, patients, and insurance representatives.