We are seeking a detail-oriented, highly organized Medical Billing and Coding Specialist to join a healthcare team focused on providing judgment-free sexual and reproductive healthcare, including abortion care, gynecologic services, and gender-affirming care.
In this role, you will translate patient medical records into standardized codes, manage the end-to-end insurance claims process, and help optimize revenue cycle management by ensuring accurate documentation translation and compliant reimbursement from insurance payers.
You will also support claims follow-up, insurance verification, denial resolution, patient account inquiries, and overall compliance with HIPAA, OIG regulations, and internal policies.
Responsibilities
- Review, analyze, and translate clinical documentation, physician notes, and laboratory reports into accurate ICD-10-CM, CPT, and HCPCS Level II codes.
- Prepare, validate, and electronically transmit clean insurance claims to commercial carriers, Medicare, and Medicaid.
- Verify patient insurance eligibility and benefits, and coordinate pre-authorizations or referrals as needed.
- Monitor claim status, identify rejections and denials, correct errors, and submit formal appeals.
- Track accounts receivable and follow up on outstanding patient and insurance balances.
- Answer patient questions about statements, explanation of benefits, and payment plans.
- Maintain confidentiality and follow HIPAA, OIG, and internal compliance requirements.
- Perform other duties as assigned.
Qualifications
- High school diploma or equivalent required.
- Associate degree in Health Information Technology or a related field preferred.
- 2-3 years of direct experience in medical billing and coding within a clinic, hospital, or billing agency.
- Preferred experience in women’s health, including OBGYN or family planning.
- Proficiency with EHR/EMR systems and clearinghouse platforms, such as AthenaHealth.
- Strong understanding of medical terminology, anatomy, physiology, and payer guidelines.
- Strong analytical, mathematical, communication, and organizational skills.
Location
Pittsburgh, Pennsylvania, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 month ago