Classify medical data from patient records to assign ICD-10-CM and CPT codes for primary and multi-specialty physician billing. Reviews clinical billing for coding and billing accuracy. Reviews claim denials for coding-related issues and assists CBO collectors with resolution. Demonstrates knowledge of reimbursement guidelines and changes in payer policy. Provides guidance to clinical staff and providers where necessary. Serves as a resource for clinics on coding issues and questions as needed. May supervise an individual billing team of non-certified billers and collectors. Performs research on coding changes and payer policies on an ongoing basis.
Qualifications:
- High School Diploma or GED (Required)
- Vocational / Technical Degree (Preferred)
- 2 year / Associate Degree in Health Information Management (Preferred)
Experience:
- 2 - 3 years Diagnosis and CPT coding in a clinic, business, or revenue cycle environment or any combination thereof (Preferred)
- 2 - 3 years Broad knowledge of medical terminology and anatomy (Preferred)
Licenses and Certifications:
- Required: Coding Certification (CPC or CCS)
- Preferred: CPMA
Skills and Responsibilities:
- Review medical records to assign ICD-10-CM, CPT, and HCPCS Level II codes and modifiers for accurate primary and multi-specialty billing.
- Provide analysis and education on coding trends and payer policy changes to providers and staff.
- Review claim denials for coding issues, interpret payer guidelines, assist insurance collectors with resolution, and prepare or assist with appeals.
- Perform coding duties accurately and timely to ensure appropriate reimbursement and maintain revenue flow continuity.
Additional Duties:
- Adhere to hospital and departmental attendance and punctuality guidelines.
- Perform all job responsibilities aligned with the organization's core values, mission, and vision.
- Maintain current knowledge through ongoing education.
- Attend staff meetings and complete mandatory in-services and competency evaluations.
- Demonstrate competency in providing care based on patient age, sex, weight, and needs.
- Use age-specific customer service skills where applicable.
- Wear protective clothing and equipment when appropriate.
- High School Diploma or GED required
- Vocational / Technical Degree preferred
- 2 year / Associate Degree in Health Information Management preferred
- 2 - 3 years experience in Diagnosis and CPT coding preferred
- Knowledge of medical terminology and anatomy preferred
- Coding Certification (CPC or CCS) required
- CPMA certification preferred
Location
Georgia, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago