Job Description

We are seeking a highly skilled and detail-oriented Medical Billing Specialist to join our team. This position is responsible for accurately coding medical records and claims, ensuring compliance with all coding conventions and guidelines. The ideal candidate will be proficient in ICD-10, CPT, and HCPCS coding, with experience in specialty coding and a thorough understanding of National and Local Coverage Determinations (NCD & LCD), Correct Coding Initiatives (CCI), and Mutually Unlikely Edits (MUE).

Key Responsibilities

  • Accurate Coding: Apply ICD-10, CPT, and HCPCS coding conventions and guidelines to code medical records and claims accurately.
  • Compliance: Ensure coding practices comply with National and Local Coverage Determinations (NCD & LCD), Correct Coding Initiatives (CCI), and Mutually Unlikely Edits (MUE).
  • Modifiers and Corrected Claims: Apply appropriate modifiers and handle corrected claims to ensure accurate billing and reimbursement.
  • Specialty Coding: Perform specialty coding as required, leveraging experience and knowledge in specific medical fields.
  • Quality Assurance: Participate in quality assurance and audit processes to maintain high standards of coding accuracy.
  • Communication: Collaborate with healthcare providers, billing staff, and other stakeholders to resolve coding issues and discrepancies.
  • Documentation: Maintain accurate and detailed records of coding activities and ensure proper documentation of all coding decisions.
  • Continuous Learning: Stay updated with the latest coding guidelines, industry trends, and best practices through continuous education and professional development.

Qualifications

  • Education: Associate's degree in Health Information Management, Medical Coding, or a related field. A bachelor's degree is preferred.
  • Certification: Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) credential is required.
  • Experience: Minimum of 2 years of coding experience in a fee-for-service or healthcare setting. Specialty coding experience is preferred.
  • Technical Skills: Proficient in ICD-10, CPT, and HCPCS coding conventions and guidelines. Familiarity with coding software and electronic health records (EHR) systems.
  • Knowledge: In-depth understanding of National and Local Coverage Determinations (NCD & LCD), Correct Coding Initiatives (CCI), and Mutually Unlikely Edits (MUE).
  • Attention to Detail: Strong analytical and problem-solving skills with a keen eye for detail.
  • Communication: Excellent verbal and written communication skills. Ability to work collaboratively with healthcare providers and other team members.
  • Ethics: High level of integrity and ethical standards in handling sensitive patient information.
  • Adaptability: Ability to adapt to changing regulations and industry standards.
  • Professional Development: Commitment to continuous education and professional growth in the field of medical coding.

Benefits

  • Competitive salary based on experience and qualifications
  • Comprehensive health, dental, and vision insurance plans
  • Retirement savings plan with employer matching
  • Paid time off and holidays
  • Professional development opportunities and support for continuing education