Clinic Claims Coordinator

Job Summary

This position is responsible for reviewing all provider billing information, correcting errors, and creating accurate claims in Athena on the day of service. The role works directly with clinic teams and Providers to obtain missing or incomplete information needed to complete claims and ensures compliance with billing and coding requirements. This position also identifies billing education needs and communicates trends and issues to management.

Key Responsibilities

• Review provider billing information to ensure billing tabs are marked as reviewed.
• Verify that all required CPT and ICD-10 codes are present and accurate.
• Enter undocumented ICD-10 codes into patient encounters as appropriate.
• Ensure correct use of modifiers when applicable.
• Validate units for injections to ensure accuracy.
• Complete National Drug Code (NDC) information for compound injections and Gadavist claims.
• Select appropriate laterality for x-rays and viscosupplementation injections.
• Remove administration fees for viscosupplementation and Gadavist procedures when applicable.
• Enter supervising provider information for Physician Assistant, Nurse Practitioner, and DME/Casting clinics.
• Contact clinic staff to obtain missing or incomplete information required to finalize claims.
• Communicate incomplete billing tabs and missing documentation to Providers in a timely manner.
• Provide regular reports to management on billing error trends related to claim creation.
• Provide updates to the Revenue Cycle Manager and Director regarding delinquent Provider claims.
• Escalate Provider education needs related to proper billing and coding practices.
• Ensure compliance with all company plans, policies, and procedures.
• Perform all other duties as assigned.

Education and Experience

• High School Diploma required.
• Minimum of 2–3 years of medical billing and coding experience required.
• Experience using Athena preferred.

Preferred Qualifications and Skills

• Working knowledge of CPT and ICD-10 coding standards.
• Strong attention to detail and accuracy.
• Effective written and verbal communication skills.
• Ability to work collaboratively with Providers and clinic staff.
• Strong organizational skills and ability to manage multiple priorities.
• Ability to work effectively in a fast-paced healthcare environment.

Orthopaedic Solutions Management is a Drug Free Workplace

We are committed to maintaining a safe, healthy, and productive work environment. As part of this commitment, we operate as a drug-free workplace. All candidates will be required to undergo pre-employment drug screening and/or be subject to random drug testing in accordance with applicable laws and company policy.