Medical Billing and Coding Specialist

Overview
Join our dynamic healthcare team as a Medical Billing and Coding Specialist! In this vital role, you will be the driving force behind accurate medical billing processes and precise coding practices that ensure seamless reimbursement and compliance. Your expertise will help streamline operations, improve revenue cycles, and support quality patient care. If you thrive in a fast-paced environment and are passionate about healthcare administration, this opportunity is perfect for you to make a meaningful impact every day!

Responsibilities

• Review and analyze medical records to assign appropriate ICD-10 (International Classification of Diseases, 10th Revision), CPT (Current Procedural Terminology), and DRG (Diagnosis-Related Group) codes accurately.
• Prepare and submit claims using Electronic Medical Record (EMR) or Electronic Health Record (EHR) systems, ensuring all billing information aligns with coding standards.
• Verify insurance coverage, process payments, and follow up on unpaid or denied claims through effective medical collection strategies.
• Maintain detailed and organized medical records, ensuring all documentation complies with healthcare regulations and privacy laws.
• Collaborate with healthcare providers to clarify documentation or coding discrepancies for precise billing.
• Stay updated on changes in ICD coding (including ICD-9 to ICD-10 transition), CPT updates, and insurance policies to ensure ongoing compliance.
• Assist in auditing billing processes and coding accuracy to optimize revenue cycle management.

Qualifications

• Proven experience in medical billing, medical coding, or related healthcare administrative roles.
• Strong knowledge of ICD-10, ICD-9 (legacy systems), CPT coding, DRG classifications, and medical terminology.
• Familiarity with EMR/EHR systems used for documentation and billing purposes.
• Excellent understanding of medical records management and healthcare compliance standards.
• Ability to interpret complex medical documentation accurately and apply appropriate codes efficiently.
• Effective communication skills to collaborate with providers, insurance companies, and patients as needed.
• Certification in Medical Coding (such as CPC or CCS) is preferred but not mandatory. Embark on a rewarding career where your skills directly contribute to efficient healthcare delivery! We are committed to fostering a supportive environment that values your expertise in medical billing and coding while offering opportunities for professional growth.

Benefits:

• 401(k) matching
• Dental insurance
• Flexible schedule
• Health insurance
• Vision insurance

Work Location: Hybrid remote in Sebring, FL 33870