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, with active involvement in community health fairs and volunteering initiatives. We are a highly reputed medical practice in North Atlanta, offering strong growth opportunities and robust benefits for our employees. Be a part of our dynamic team and take your career to the next level with Pandya Medical Center.
The Senior 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.
This is a full-time, Monday-Friday in-office position. The ideal candidate must be located in Georgia and able to be present at the administrative office in the Johns Creek area.
Duties and 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.
- Minimum of 5 years’ experience with medical billing and revenue cycle in a medical setting.
- Certified Professional Coder through AAPC.
- Knowledge of insurance guidelines including HMO/PPO, Medicare and other payers’ requirements and systems.
- Knowledge of CPT, ICD-10, HCPCS Coding and use of modifiers.
- Knowledge of medical billing rules, modifiers, and strong understanding of EOBs and ERAs.
- Competent computer skills including Microsoft Office or similar software.
- Experience with AthenaHealth EHR preferred or other EHR systems like 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 multitask and prioritize work in a fast-paced, team environment.
- Problem-solving skills to research and resolve discrepancies, denials, appeals, collections.
- Strong understanding of patient confidentiality as per HIPAA.
- Health insurance
- Dental and Vision plans
- Aflac Supplemental insurance plans
- 401K match plan with up to 4% by Pandya Medical Center
- Paid Time Off
Location
Georgia, US
Employment Type
Full-time
Experience Level
Senior
Salary Range
$49,920 - $60,320
Remote work allowed
No
Posted
4 weeks ago