Dermatology Insurance A/R Biller and Coder

Arizona Center for Cancer Care•Scottsdale, AZ

3d•Hybrid

About The Position

The dermatology insurance A/R biller and coder at Arizona Center for Cancer Care (AZCCC) is responsible for translating clinical documentation into accurate billing codes and managing the revenue cycle from claims submission through payment collection. This role reports to the Dermatology Billing Lead and works closely with them and fellow team members to ensure accurate charge capture, timely and clean claims submission, effective denial resolution, and healthy accounts receivable performance. This role may be performed remotely or in-office.

Requirements

High School education
Experience in medical billing and coding, specifically in dermatology.
Proficiency in assigning CPT and ICD-10 codes.
Knowledge of insurance payer guidelines (commercial, Medicare, Medicaid).
Experience with revenue cycle management.
Familiarity with practice management systems and clearinghouses.
Understanding of HIPAA, payer guidelines, and CMS regulations.
Valid driver’s license and reliable transportation for travel between locations.

Nice To Haves

CPC or other relevant coding certification.
Experience with Mohs micrographic surgery, cryotherapy, and cosmetic procedures billing.
Experience with remote or hybrid work environments.

Responsibilities

Reviews provider documentation to assign accurate CPT and ICD-10 codes for visit types ranging from routine skin checks to biopsies, excisions, Mohs micrographic surgery, cryotherapy, and cosmetic procedures.
Applies correct modifiers to reflect multiple procedures performed in a single visit, in accordance with payer and coding guidelines.
Query providers for clarification when documentation is incomplete or does not support the code being billed.
Prepares and submit clean claims to insurance payers (commercial, Medicare, Medicaid) via clearinghouse in a timely manner.
Verifies that claims include all required documentation, prior authorizations, and referral information prior to submission.
Distinguish cosmetic (self-pay/non-covered) procedures from medically necessary ones to ensure proper billing pathway.
Monitors outstanding claims and follow up on unpaid or aged accounts according to A/R aging reports.
Investigates and resolve claim denials, rejections, and underpayments; resubmit corrected claims and file appeals with supporting documentation as needed.
Post payments, adjustments, and write-offs accurately in the practice management system, and reconcile insurance payments against contracted fee schedules.
Identifies root causes of denials and escalate recurring trends to the Billing Lead, partnering with front office/scheduling staff to help prevent repeat issues (e.g., missing referrals, expired authorizations).
Generates patient statements for balances after insurance adjudication (copays, coinsurance, deductibles, non-covered cosmetic services).
Responds to patient billing inquiries and set up payment plans as needed, escalating complex issues to the Billing Lead.
Maintains audit-ready documentation for all coding decisions and support internal or external billing audits as needed.
Maintains compliance with HIPAA, payer guidelines, and CMS regulations in all billing and coding activity.
Tracks and report daily/weekly work completed per practice tracking procedures.
Performs other duties as assigned by management.