Billing and Coding Specialist - OSMI - Sleep Medicine

MedAmerica • Dublin, OH

14h • Onsite

About The Position

This position reviews clinical documentation to assign accurate ICD-10-CM diagnosis and CPT/HCPCS procedure codes for sleep medicine services (including polysomnography, home sleep apnea testing, MSLT, and MWT), and performs front-end and back-end billing functions including insurance verification, prior authorization, claims submission, and denial/collections follow-up. The role requires working knowledge of both coding compliance standards and revenue cycle practices to ensure accurate, timely, and compliant reimbursement for sleep medicine services. At Vituity we know the impact you can have.

Requirements

• High school diploma or GED required.
• Minimum of 2 years of experience in medical billing and/or medical coding, including diagnosis and procedure code assignment Required.
• Proficiency in medical terminology and coding systems, including ICD-10-CM, CPT, and HCPCS Level II, and billing/practice-management software required.
• Knowledge of medical collection practices and procedures
• Strong attention to detail and accuracy in coding and billing processes
• Excellent communication skills to interact with patients, insurance companies, and healthcare providers
• Ability to work independently and prioritize tasks in a fast-paced environment.
• Ability to read and interpret Explanation of Benefits (EOB) and remittance advice from various payers.
• Knowledge of coding compliance guidelines, including CMS National Correct Coding Initiative (NCCI) edits and payer-specific coverage policies (LCD/NCD).
• Ability to interpret clinical documentation to support accurate diagnosis and procedure code selection

Nice To Haves

• Certified Professional Coder (CPC) or Certified Billing and Coding Specialist (CBCS) certification preferred.
• Experience coding and billing for sleep medicine or pulmonary specialty services (e.g., polysomnography, home sleep apnea testing, MSLT, MWT) preferred.
• Associate's degree in health information technology, medical billing and coding, or a related field preferred.

Responsibilities

• Review and analyze medical records and documentation to ensure accurate coding and billing
• Assign appropriate ICD-10-CM, CPT, and HCPCS Level II codes to diagnoses and procedures for sleep medicine services (e.g., polysomnography, home sleep apnea testing, MSLT, MWT)
• Query providers for clarification when clinical documentation does not support accurate code assignment
• Apply CMS National Correct Coding Initiative (NCCI) edits and payer-specific coverage policies (LCD/NCD) to ensure compliant code selection
• Maintain current knowledge of annual ICD-10-CM, CPT, and HCPCS code-set updates and sleep medicine coding guidelines
• Maintain confidentiality of patient information in accordance with HIPAA regulations
• Verify patient insurance coverage and obtain necessary authorizations for services
• Prepare and submit claims to insurance companies for reimbursement
• Follow up on unpaid or denied claims and resolve any billing discrepancies
• Interpret Explanation of Benefits (EOB) and remittance advice to resolve payment discrepancies and identify denial trends
• Collaborate with medical office staff to ensure accurate and timely billing processes

Benefits

• Superior health plan options
• Dental, Vision, HSA/FSA, Life and AD&D coverage, and more
• Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6%25 plus discretionary profit-sharing contributions (eligible January following 18 months of service)
• Outstanding Paid Time Off: Start at 4 weeks’ PTO, Paid holidays, Sabbatical
• Student Loan Refinancing Discounts
• Professional and Career Development Program
• EAP and travel assistance included
• Wellness program
• Commuter Benefits Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED