Medical Coder/Biller

SFM - The Work Comp Experts•Bloomington, MN

6h•$26 - $40•Hybrid

About The Position

Since 1983, SFM has been the workers’ compensation partner of choice for agents, employers and their workers. When a workplace injury occurs, employees need to know they will receive timely assistance and support throughout the process. As a member of the Medical Bill Review team, you’ll ensure that the medical bills injured workers incur are paid accurately according to the workers’ compensation guidelines. Verifying the billing codes are correct, following state appropriate workers’ compensation guidelines and producing high-quality work is a key function in this position. You will look at billing practices of medical providers and participate in conferences to address payment rationale as well as maintaining positive team relationships with internal and external customers. Depending on your experience and education you may be hired as an Associate Medical Support Representative or Medical Support Representative. Salary and training will be based on your experience. SFM offers a flexible hybrid work environment, so some office time is required. The Corporate Headquarters are in Minnesota. Apply today and you will discover why SFM retains their employees and is considered an excellent place to grow your career.

Requirements

Associate degree or bachelor’s degree in medical bill coding/health information, nursing, or similar field preferred; in lieu of a formal degree, two or more years of technical training or work experience in a medical coding, medical billing, or insurance environment is accepted.
One or more years’ experience working in a customer facing environment highly desirable; experience working in a medical clinic or insurance environment is a plus.
Medical coding certification is preferred, or willing to obtain certification with 18 months of employment.
Knowledge of workers’ compensation insurance and/ or medical coding experience preferred.
Ability to understand and use analytical skills relating to business interpretation of medical documents, including CPT, ICD, HCPS, CMS and bundling. Basic math skills and is good with numbers.
High attention to detail and accuracy
Excellent communication and customer service skills

Nice To Haves

Candidates who possess a certification from either the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA), in addition to the aforementioned skills, may be considered for a higher-level role.

Responsibilities

Review and process medical bills using the Mitchell system, ensuring accuracy and adherence to workers’ compensation guidelines
Meet production and quality standards while maintaining timely turnaround
Analyze medical billing codes (CPT, ICD, HCPCS, CMS) and apply proper reimbursement practices
Identify overpayments, submit refund requests, and escalate concerns appropriately
Manage provider appeals and reconsiderations with professional and compliant communication
Investigate potentially improper billing patterns (overutilization, fraud, errors) and escalate as needed
Collaborate with vendors and internal stakeholders to support bill review processes
Provide high-quality customer support and contribute ideas to improve team efficiency