Medical Coder

Responsible for coding audits and billing support for physicians and advanced practice providers in a urology practice. This role supports the Billing Department by maintaining coding accuracy, charge entry integrity, reimbursement workflows, and compliance with Medicare, HIPAA, and OSHA requirements.

Key responsibilities include:

• Maintain physician and APP credentialing files and related insurance payor files.
• Support licensure and CME tracking.
• Organize coding, insurance carrier, managed care, and credentialing information for easy reference.
• Review physician coding at charge entry for Medicare compliance and accurate reimbursement.
• Audit charts quarterly and provide feedback on documentation and charge capture deficiencies.
• Prepare quarterly audit reports for financial leadership.
• Provide billing, coding, managed care, insurance, and reimbursement information to physicians and managers.
• Maintain and update coding sets in Athena according to regulatory changes and uncovered work performed.
• Enter professional charges for office and hospital services with accuracy and timeliness.
• Post payments, adjustments, and refunds according to practice protocol.
• Balance all charge and payment batches before posting.
• Verify demographic and insurance information during charge entry.
• Follow up on returned claims, denials, correspondence, and rebills in a timely manner.
• Submit primary and secondary claims electronically and via HCFA as required.
• Provide customer service to patients and authorized representatives regarding patient accounts.
• Maintain an organized, efficient, and professional work environment.