Medical Dental Coder

This vital position in the healthcare delivery system focuses on the fiscal aspects of the clinic. Responsibilities include billing and submitting claims via AthenaOne EMR, following up on claim statuses, resolving denials, submitting appeals, posting payments and adjustments, and managing collections. The role requires excellent customer service, telephone etiquette, computer skills, professional appearance, attention to detail, multitasking, and the ability to work well under pressure and as part of a team.

Communication involves interaction with outside providers and insurance representatives to resolve billing issues and fee collections positively and professionally. Primary billing duties include reviewing and analyzing medical records for accurate diagnosis and coding (CPT, HCPCS), billing according to policies, entering charges into the database accurately, verifying insurance, performing root cause analysis to improve processes, and maintaining productivity to meet deadlines and maximize revenue.

The role may involve traveling to different clinics for training or information gathering. Secondary collections tasks include submitting claims electronically, resolving edits, obtaining referrals and authorizations, handling denials and appeals, reviewing EOBs, posting payments accurately, and managing correspondence. The coder works closely with physicians and departments to resolve issues and educates staff to minimize denials. Documentation management ensures all billing and collection records are accurate and current.

The position upholds safe professional conduct, timely documentation, and adherence to clinic policies and schedules. This is a non-supervisory role.

Knowledge and skills required include the PCMH model, South Carolina policies and procedures, medical billing practices, ICD-10 and CPT coding, Microsoft Office, customer relations, document accuracy, billing and coding proficiency, bilingual fluency in English and Spanish, and the ability to maintain confidentiality and a positive work environment in a fast-paced setting.

Minimum qualifications include a high school diploma or GED, billing and coding certification from an accredited program, and at least one year of billing experience in adults, pediatrics, or women's health services.

Special instructions note that the role involves handling cash and billing with a requirement to reserve five consecutive annual leave days per year. Travel is required, and a valid Texas driver's license and liability insurance are mandatory if using a personal vehicle. Work hours may extend beyond the usual shift to meet patient care and service needs.