Billing and Coding Specialist - OSMI - Sleep Medicine - Ohio Sleep Medicine Institute

Vituity•Columbus, OH

18h•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. Join the Vituity Team. At Vituity we’ve cultivated an environment where passion thrives, and success comes through shared purpose. We were founded in a culture that values team accomplishments more than individual achievements, an approach we call “culture of brilliance.” Together, we leverage our strengths and experiences to make a positive impact in our local communities. We foster this through shared goals and helping our colleagues succeed, and we also understand the importance of recognition, taking the time to show appreciation and gratitude for a job well done. Vituity Locations: Vituity has opportunities at 900 practices across the country, serving 14.5+ million patients a year. With Vituity, if you ever need to move, you can take your job with you.

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% 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
Purpose-driven culture focused on improving the lives of our patients, communities, and employees