Medical Coder & Insurance Collector - Spine Diagnostics

Resolve Pain Solutions•Baton Rouge, LA

About The Position

Resolve Pain Solutions is committed to improving the quality of life for individuals experiencing chronic and acute pain. We are seeking a detail-oriented Medical Coder & Insurance Collector to join our growing team. Our administrative and billing professionals play a vital role in supporting patient care by ensuring accurate coding, timely claim submission, and efficient reimbursement from insurance providers. This position supports both the coding and collections functions of the revenue cycle, helping ensure services are coded correctly and payments are collected promptly. Position Summary The Medical Coder & Insurance Collector is responsible for reviewing clinical documentation, assigning appropriate medical codes, submitting and following up on insurance claims, and resolving denied or unpaid claims. This role requires a strong understanding of outpatient coding, pain management procedures, ambulatory surgery center (ASC) services, and insurance claims processes. The ideal candidate is highly detail-oriented, knowledgeable in coding guidelines and insurance billing practices, and able to independently research and resolve claim issues to ensure timely reimbursement.

Requirements

AAPC or AHIMA certification preferred (CPC, CCS, or equivalent), or minimum 1 year of medical coding experience while actively pursuing certification.
Experience with outpatient, pain management, or ASC coding strongly preferred.
Minimum 1–3 years of medical billing, insurance collections, or revenue cycle experience.
Strong knowledge of commercial insurance and Medicare payer requirements.
Ability to interpret EOBs and denial codes and take appropriate corrective action.
Familiarity with electronic health records (EHR) and medical billing software systems.
Strong attention to detail, problem-solving, and organizational skills.
Excellent communication and time management abilities.
Ability to manage multiple priorities in a fast-paced healthcare environment.

Responsibilities

Review clinical documentation and assign accurate codes for outpatient and ASC procedures.
Ensure coding accuracy and compliance with AAPC/AHIMA guidelines, payer policies, and regulatory requirements.
Maintain knowledge of pain management coding practices and procedure documentation standards.
Identify and resolve documentation discrepancies with providers or clinical staff when necessary.
Utilize various billing and coding software platforms to process coding assignments.
Review outstanding claims to identify reasons for non-payment, underpayment, or denial.
Interpret and analyze Explanation of Benefits (EOBs) and payer responses.
Correct and rebill claims when necessary to ensure proper reimbursement.
Prepare and submit appeals for denied or rejected claims.
Process adjustments, write-offs, and refunds in accordance with company policies and payer requirements.
Communicate with insurance companies to resolve claim issues and obtain claim status updates.
Monitor accounts receivable and follow up on outstanding balances to ensure timely collections.
Meet established deadlines and productivity expectations for coding and claim follow-up activities.
Maintain accurate documentation of coding decisions and collection activities in billing systems.
Work collaboratively with internal teams to ensure efficient revenue cycle processes.
Identify trends in denials or billing errors and communicate potential improvements to leadership.
Maintain an organized work environment and ensure accuracy in all work performed.
Maintain patient confidentiality and comply with HIPPA privacy and security standards.
Follow company policies and procedures as outlined in the Personnel Policies Manual.
Maintain a professional and cooperative working relationship with colleagues.
Perform other reasonable duties as assigned by leadership.