Responsible for reviewing patient medical records after clinic visits and translating documentation into billing codes used by insurers for claim processing and reimbursement. This role supports accurate charge capture, coding compliance, and clean claim submission.
Key responsibilities include:
- Assigning and sequencing ICD-10-CM, CPT, and HCPCS/modifier codes for each patient encounter in accordance with coding guidelines and legal requirements.
- Ensuring professional and physician billing codes are assigned accurately and sequenced appropriately.
- Querying providers or clinic team members when documentation is unclear, incomplete, or ambiguous.
- Assigning and entering charges such as E&M levels, infusions/injections, and observation hours.
- Identifying and reporting discrepancies, potential quality concerns, and billing issues.
- Reviewing records to ensure documentation supports ordered services and meets medical necessity.
- Following the Standards of Ethical Coding and official coding guidelines.
- Maintaining confidentiality and safeguarding sensitive records.
- Participating in continuing education to stay current on coding and reimbursement requirements.
- Performing other related duties as assigned.
Requirements & Qualifications
Qualifications
Minimum qualifications
- Strong communication and interpersonal skills, including fluency in oral and written English.
- Basic computer skills, including email, navigating information technology systems, and using electronic health record tools.
- Excellent attention to detail and organizational skills.
- Ability to adapt procedures, tools, and techniques to meet job requirements.
Education and experience
- High school diploma or equivalent required.
- At least 2 years of progressively responsible experience in medical insurance, medical billing, or medical reimbursement preferred.
- Knowledge of CPT and ICD-10 coverage policies, coding guidelines, revenue cycle coding processes, and billing practices.
- Ability to read and interpret E&M notes, diagnostic study results, endoscopic reports, interventional notes, and operative notes.
- Ability to confirm or change CPT codes, diagnosis codes, and modifiers based on documentation review.
- Strong understanding of carrier coverage policies and documentation requirements for specialty services.
- Ability to work independently and adapt quickly in urgent situations.
Certifications
- Certified Professional Coder (CPC), Certified Medical Coder (CMC), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), or Certified Professional Auditor (CMPA), or equivalent required.
- Certification may be obtained within 6 months of hire or transfer if applicable.
- If travel is required, a valid driver's license and automobile liability insurance must be maintained.
Location
Oklahoma, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
3 weeks ago
Browse More Jobs