At Pandya Medical Center, we believe in going above and beyond for every patient. Our team members are dedicated professionals who truly care about making a difference. We listen, understand, and treasure each personal story shared by our patients. Our commitment extends beyond our clinic walls, including involvement in community health fairs and volunteering initiatives. We're a highly reputed medical practice in North Atlanta, offering strong growth opportunities and robust benefits.

The Medical Billing & Coding Specialist assures accurate and complete coding information is collected and reported to private insurance and Medicare to support the revenue cycle. Responsibilities include scrubbing encounters for accurate coding before claim creation, ensuring correct modifiers and ICD10 codes for each CPT, timely claim submissions, and following up on claim denials. The role requires knowledge of insurance regulations and medical coding, aiming to maximize accurate third-party billing and minimize denials. The position is full-time with competitive salary and strong benefits including PTO, health insurance, and 401k match. The candidate should be located in Georgia and able to attend the Johns Creek administrative office.

Duties and Responsibilities:

Submit medical claims promptly to insurers and payers
Review and analyze medical records for appropriate diagnosis and procedure coding
Document unclear or insufficient claims information for providers and management
Assign or reassign CPT, HCPCS, and ICD-10-CM codes as needed
Follow up on unpaid claims and appeal denied claims within 30 days
Track claims progress through clearinghouse and resolve issues
Resolve patient billing inquiries via phone and email promptly
Stay current on healthcare regulations, medical terminology, and coding practices
Follow HIPAA guidelines for patient information confidentiality

Qualifications and Skills:

Minimum 3 years medical billing and revenue cycle experience in medical setting
Certified Professional Coder (CPC) through AAPC
Knowledge of insurance guidelines (HMO/PPO, Medicare) and systems
Expert in CPT, ICD-10, HCPCS coding and modifiers
Strong understanding of medical billing rules, EOBs, and ERA
Computer proficient, Microsoft Office or similar
Experience with AthenaHealth or similar EHR (Epic, eClinicalWorks) preferred
Familiarity with Family Practice and Primary Care outpatient billing preferred
Exceptional customer service for patient billing and payments
Self-motivated with multitasking and prioritization skills in fast-paced environment
Problem-solving skills for discrepancies, denials, appeals, collections
Strong knowledge of HIPAA patient confidentiality regulations

Salary: $22.00 - $26.00 per hour (approximately $45,760 - $54,080 annually)

Benefits:

Health insurance
Dental and vision plans
Aflac supplemental insurance
401K matching up to 4%
Paid time off