We are seeking a detail-oriented surgical Biller and Coder with proven experience to lead the daily operations of our billing and coding department at our Babylon office. The ideal candidate will have strong leadership skills, a deep understanding of surgical billing and coding processes, and the ability to ensure accuracy, compliance, and efficiency across the department.
- Manage the end-to-end billing lifecycle for surgical and non-surgical services, from charge entry and claim submission through final resolution.
- Ensure timely and accurate submission of claims, medical records, and operative reports through payer and insurance portals.
- Monitor, analyze, and resolve claim denials, underpayments, and payment delays, including proactive follow-up to ensure timely reimbursement.
- Initiate, track, and manage reconsiderations, disputes, and first- and second-level appeals in accordance with payer guidelines.
- Perform consistent claim status follow-up to drive claims to resolution and minimize aging accounts receivable.
- Review and validate operative reports and clinical documentation to ensure coding accuracy, completeness, and compliance.
- Assign and oversee accurate CPT, ICD-10-CM, including appropriate modifier usage per CMS and payer rules.
- Conduct regular coding and billing audits to ensure compliance, reduce errors, and protect revenue integrity.
- Collaborate closely with providers, coders, and clinical staff to clarify documentation requirements and resolve complex coding or billing scenarios.
- Serve as a subject matter expert and escalation point for complex billing, coding, and payer-related issues.
- Be a self-starter, and flexibility and willingness to learn to use new EHR medical systems a must.
Requirements & Qualifications
- 3–5+ years of experience in surgical billing and coding; neurosurgical experience a plus.
- Strong knowledge of CPT, ICD-10, and HCPCS coding.
- Strong computer skills and knowledge of applications like Excel, Office, Google Workspace.
- Familiarity with payer guidelines, claims management, and reimbursement processes.
- Excellent organizational, leadership, and communication skills.
- High level of professionalism, discretion, and attention to detail.
- Familiarity with EMR systems like Athena practice and eClinical a plus.
- Familiarity with SaaS cloud EHR billing systems like advancedM preferred.
- Billing and coding certification required.
Benefits & Perks
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Location
New York, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
3 months ago