Coding Specialist / Insurance Reimbursement Specialist

Neuroscience Group•Appleton, WI

just now•$24 - $30•Onsite

About The Position

Join the team at Neuroscience Group, the region’s leader in brain, spine, and pain care! We are seeking a Coding Specialist / Insurance Reimbursement Specialist to support our Revenue Cycle team in a fast-paced, multi-specialty healthcare environment. This unique position combines medical coding and insurance reimbursement responsibilities into one dynamic role. The ideal candidate will have experience in both coding and insurance follow-up; however, we are willing to train the right candidate in the area where they may have less experience. The Coding Specialist / Insurance Reimbursement Specialist serves as a key resource within the Revenue Cycle team by supporting accurate coding, claim reimbursement, denial management, insurance follow-up, and compliance initiatives within a multi-specialty neuroscience practice environment. This position works collaboratively with providers, billing staff, leadership, patients, and insurance carriers to ensure accurate charge capture, compliant coding practices, timely reimbursement, and resolution of billing discrepancies. The role requires advanced knowledge of medical coding, payer guidelines, reimbursement methodologies, and regulatory compliance standards.

Requirements

High school diploma or equivalent required.
Minimum of 2–3 years of experience in medical coding, insurance reimbursement, accounts receivable, or medical billing required.
Strong understanding of CPT, ICD-10-CM, HCPCS coding, medical terminology, insurance reimbursement, and accounts receivable processes.
Knowledge of payer guidelines, insurance regulations, and denial management processes.
Excellent analytical, problem-solving, and critical-thinking abilities.
Strong organizational skills and attention to detail.
Ability to multitask and prioritize work in a fast-paced environment.
Strong verbal and written communication skills.
Ability to work independently and collaboratively within a team environment.
Proficiency in electronic health records (EHR), practice management systems, Microsoft Office, and payer web portals.
Ability to maintain professionalism and confidentiality in all interactions.

Nice To Haves

Advanced education or certification in Medical Coding, Health Information Management, Medical Billing, or related field preferred.
Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification preferred.
Experience in a multi-specialty medical practice preferred.

Responsibilities

Review and assign appropriate CPT, ICD-10-CM, HCPCS, and modifier coding based on provider documentation, payer requirements, and organizational billing policies.
Analyze clinical documentation to ensure accurate and compliant coding and charge capture practices.
Serve as a resource to providers and staff regarding coding guidelines, documentation requirements, and reimbursement policies.
Assist with coding audits, reviews, and compliance initiatives.
Identify coding trends, reimbursement concerns, and denial patterns and provide recommendations for improvement.
Support ongoing education and training related to coding, billing, and documentation requirements.
Maintain current knowledge of coding updates, payer regulations, and reimbursement guidelines through continuing education, webinars, publications, and professional organizations.
Review payer reports and accounts receivable activity to ensure timely and accurate reimbursement.
Investigate denied, rejected, underpaid, or unresolved insurance claims utilizing payer portals, electronic systems, and direct communication with insurance carriers.
Prepare and submit claim appeals and supporting documentation as necessary.
Work collaboratively with billing staff and leadership to reduce denials and improve reimbursement outcomes.
Assist with billing work queues, payment posting discrepancies, and reimbursement-related issues.
Monitor and resolve claim edits and payer-specific billing concerns.
Recommend process improvements to increase operational efficiency and reimbursement accuracy.
Communicate professionally and compassionately with patients regarding billing, insurance, and account-related questions.
Provide exceptional customer service while maintaining confidentiality and professionalism.
Assist patients in understanding insurance processing, claim status, and reimbursement concerns.
Adhere to all organizational policies and procedures related to billing, coding, compliance, and patient confidentiality.
Maintain compliance with HIPAA, CMS, federal, state, and payer regulations.
Complete all required compliance and regulatory training.
Participate in departmental meetings, training sessions, and special projects as assigned.
Maintain confidentiality of all patient, employee, and organizational information.
Perform additional duties as assigned to support departmental and organizational operations.