Sr. Medical Billing and Coding Specialist

Pandya Medical Center•Johns Creek, GA

20h•Onsite

About The Position

The Sr. Medical Billing & Coding Specialist assures accurate and complete coding information is collected and reported to private insurance and Medicare to help complete the revenue cycle. The specialist will scrub encounters for accurate coding prior to claim creation, assure correct modifiers and ICD10 diagnosis codes are allocated to each CPT code, ensure timely claim submissions and follow-up on claim denials. The candidate should have knowledge of insurance regulations and medical coding with the goal of maximizing accurate third-party billing and minimizing denials. The position is full time, Monday-Friday in office. The ideal candidate must be located in Georgia and able to be present at our administrative office in the Johns Creek area. If you are an experienced and motivated Sr. Medical Billing & Coding Specialist who wants to grow with a thriving medical practice, we encourage you to apply today and join our dedicated team at Pandya Medical Center.

Requirements

Minimum of 5 years’ experience with medical billing and revenue cycle in a medical setting
Certified Professional Coder thru AAPC
Knowledge of insurance guidelines including HMO/PPO, Medicare and other payers’ requirements and systems
Knowledge of CPT, ICD-10, HCPCS Coding and utilization of modifiers
Knowledge of medical billing rules, modifiers, and strong understanding of EOBs and ERAs
Competent in computer skills, Microsoft Office or similar software
Strong understanding of patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

Nice To Haves

Experience with AthenaHealth EHR is preferred or other similar EHR systems such as Epic, or eClinicalWorks
Experience with Family Practice and Primary Care outpatient billing (Preferred)
Exceptional Customer Service skills for interacting with patients regarding medical claims and payments
Self-motivated with ability to multi-task, prioritize work in a fast-paced, team environment
Problem-solving skills to research and resolve discrepancies, denials, appeals, collections

Responsibilities

Accurate and timely submission of medical claims to insurance companies and other payers
Review and analyze medical records to ensure appropriate coding of diagnoses and procedures
Document for providers and management any insufficient or unclear information on claims
Assign or reassign CPT, HCPCS, and ICD-10-CM codes as needed
Follow up on unpaid claims and initiate appeals for denied claims within 30 days of submission.
Track the progress of claims through the clearinghouse and promptly address any issues
Resolve patient billing issues and questions via phone and email in a timely fashion
Stay updated on healthcare regulations, medical terminology, and coding practices
Follow HIPAA guidelines when accessing and sharing patient information
Additional job related duties or projects as needed