We are seeking a detail-oriented and experienced Billing & Certified Medical Coder to join an Allergy & Asthma practice. This role is responsible for accurate medical coding, timely claim submission, payment posting, denial management, and compliance with payer and regulatory requirements.
This is a hybrid position in Leominster, Massachusetts with weekly in-office duties.
Responsibilities
- Accurately assign CPT, ICD-10-CM, and HCPCS codes for allergy and asthma services
- Code office visits, diagnostic testing, procedures, and treatments including allergy skin testing, immunotherapy injections, allergy serum preparation, pulmonary function testing, E/M services, and biologic medications
- Ensure documentation supports coded services and meets payer guidelines
- Prepare, submit, and monitor insurance claims for commercial, Medicare, and Medicaid payers
- Post payments, adjustments, and refunds accurately
- Identify, analyze, and resolve claim denials and underpayments
- Maintain compliance with HIPAA, CMS, and payer-specific billing regulations
- Stay current on coding updates, payer policy changes, and industry best practices
- Participate in internal audits and assist with external audits as needed
- Work closely with providers and clinical staff to clarify documentation and coding questions
- Communicate with insurance companies regarding claim issues
- Provide billing support and explanations to patients as needed
Requirements & Qualifications
Required Qualifications
- Certified Professional Coder (CPC), CCS, or equivalent coding certification
- Minimum 5 years of medical billing and coding experience, preferably in Allergy, Asthma, or Immunology
- Strong knowledge of CPT, ICD-10-CM, HCPCS, and E/M coding
- Experience with insurance claim submission and denial resolution
- Proficiency with electronic health records (EHR) and practice management systems
Preferred Qualifications
- Experience billing for allergy testing, immunotherapy, and biologic medications
- Familiarity with Medicare and commercial payer guidelines for allergy services
- Knowledge of modifier usage such as -25 and -59 in an allergy practice setting
- ECW experience preferred but not required
Skills & Competencies
- High attention to detail and accuracy
- Strong organizational and time-management skills
- Ability to work independently and as part of a team
- Excellent written and verbal communication skills
- Strong problem-solving and analytical abilities
Benefits & Perks
Benefits
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Tuition reimbursement
Location
Massachusetts, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
Yes
Posted
2 weeks ago