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The Medical Coder/Biller position is essential for ensuring that accurate claims are submitted for medical services provided. Each employee involved in the coding, billing, or claims submission process must perform their functions with accuracy and honesty, from the initial receipt of a physician's order to the final receipt of payment for services rendered. The Coding Specialist I (CS I) will be responsible for abstracting and assigning valid ICD and CPT codes, which are crucial for appropriate reimbursement in compliance with federal and state regulations. This role requires close collaboration with practice staff to ensure that coding and assignment are performed correctly. The CS I will review accounts to confirm that the assigned codes adhere to legal and insurance requirements, ensuring that all necessary signatures and authorizations are obtained before billing submissions. In cases where discrepancies arise between charges and coded procedures, the CS I is responsible for notifying the Director. If an account is denied due to incorrect coding, the CS I will conduct thorough medical records research and report findings to the Director. Additionally, the CS I must be prepared to return to work during emergencies, including inclement weather, and will occasionally be assigned other duties beyond the primary job description. To qualify for this position, candidates must pass a criminal background check and consent to random urine drug testing. A high school diploma is required, along with a minimum of an Associate Degree. Candidates should have at least one year of previous billing and coding experience, particularly in physician reimbursement, and familiarity with electronic health records is essential. A Certificate of Medical Coding from a recognized program is also required, with AAPC certification preferred. Strong organizational, verbal, and written communication skills are necessary, as well as proficiency in PC skills and customer service. The role may involve high stress due to multiple simultaneous demands, but the work environment is generally pleasant and comfortable, primarily within an office setting.
