Coding Specialist

EHP•Ann Arbor, MI

21h•Onsite

About The Position

The Coding Specialist will be responsible for accurately assigning and sequencing diagnosis and procedure codes, verifying patient demographic and insurance information, ensuring documentation compliance, resolving claim denials, and maintaining system data. This role requires a strong understanding of medical coding principles, insurance regulations, and high-accuracy data entry skills to ensure timely and accurate billing for patient transport services.

Requirements

At least 3 years of experience with Medical Insurance.
Proficiency in ICD-10-CM coding.
Familiarity with CMS (Medicare/Medicaid) billing rules.
Familiarity with private payer regulations.
Familiarity with medical necessity for emergency/non-emergency transport.
High-speed, high-accuracy data entry.
Advanced problem-solving skills.
Professional written communication skills.
Ability to interpret complex medical narratives.
A strong ability to maintain deep focus and accuracy during repetitive tasks.
Organizational skill to manage multiple "queues" or task lists simultaneously.

Responsibilities

Assign and sequence appropriate ICD-10-CM diagnosis codes and CPT/HCPCS procedure codes based on clinical documentation.
Translate patient transport data into billable charges, ensuring that the level of service billed perfectly matches the medical necessity documented in the Electronic Patient Care Report (ePCR).
Maintain a sharp, up-to-date understanding of coding bundling, modifiers, and global periods to proactively prevent claim denials.
Conduct comprehensive audits of patient information, including legal name, address, date of birth, and guarantor details for every claim.
Verify insurance eligibility and primary/secondary/tertiary coverage using clearinghouses and payer portals.
Ensure all insurance details are entered flawlessly to minimize "front-end" rejections.
Review ePCRs for signature compliance and missing clinical documentation.
Identify and flag incomplete records, preparing "send back" tasks for clinical staff or providers to ensure documentation meets legal and billing guidelines.
Monitor the "Send Back" queue to ensure corrections are returned and processed quickly.
Research and resolve basic claim edits or denials related to coding or demographic discrepancies.
Update account notes to accurately reflect the status of rebilled claims and any actions taken to resolve payment delays.
Perform critical data corrections within HealthEMS and other ePCR programs.
Coordinate with providers, clients, and internal colleagues via email and Slack to resolve billing hurdles.
Stay current on company processes and industry regulatory updates by actively participating in department meetings.