Use knowledge of medical record coding rules, insurance regulations, and federal, state, and municipal reimbursement rules to support accurate billing and claims processing. Communicate clearly with personnel, patients, clients, and insurance companies while maintaining coding and billing certification requirements.

Key responsibilities include:

Develop and update procedure and diagnosis code master files
Update organization fee schedules as needed
Work with billing and reimbursement staff to correct insurance claims
Assign CPT and ICD-10 codes from patient medical records for claims submission
Process accounts receivable items, EOBs, denials, and documentation requests
Post insurance and patient payments into the computer system
Perform internal audits of billing, reimbursement, and chart coding accuracy
Coordinate with internal and external auditors during audits
Handle patient and insurance carrier calls regarding account inquiries
Perform additional duties assigned by management

Coding Specialist

Required

Preferred