medical billing and coding specialist

One Machine Software

Medical Billing / Coding Executive Job Description We are looking for a detail-oriented Medical Coder with experience in getting approvals. The ideal candidate will be responsible for accurately coding patient diagnoses, treatments, and procedures to support proper insurance billing and compliance. This is a full-time, on-site role based in Gulberg 3, Lahore, requiring availability for night shifts. Candidates without relevant experience will not be considered.Key Responsibilities:Required Qualifications:Additional Information: This is a full-time position offering a monthly salary between Rs55,000 and Rs80,000. The role is based on-site in Gulberg 3, Lahore, and requires candidates to be available for evening shifts. Applicants must reside in Lahore to be eligible for consideration.Candidates who meet the outlined qualifications and are comfortable working evening hours are encouraged to apply.<ul><li>Understand ICD, CPT, and HCPCS codes assignments for accuracy in medical bills.</li><li>Review clinical documentation to ensure correct coding for insurance and billing purposes.</li><li>Maintain compliance with healthcare regulations and coding standards.</li><li>Work closely with healthcare providers to clarify any coding-related information when needed.</li><li>Certification as a CPC (Certified Professional Coder), CCS (Certified Coding Specialist), or an equivalent credential.</li><li>Strong understanding of medical terminology, anatomy, and disease processes.</li><li>Proven experience in medical coding, preferably within a hospital or clinical setting.</li><li>Exceptional attention to detail and strong organizational skills.</li></ul>Job Type: Full-timePay: Rs55,000.00 - Rs80,000.00 per monthWork Location: In person

Medical Billing / Coding Executive

CAN AT TOTAL

Duty Hours:3pm to 12pm3pm to 11pmJob Description We are looking for a detail-oriented Medical Coder with experience in getting approvals. The ideal candidate will be responsible for accurately coding patient diagnoses, treatments, and procedures to support proper insurance billing and compliance. This is a full-time, on-site role based in Gulberg 3, Lahore, requiring availability for night shifts. Candidates without relevant experience will not be considered.Key Responsibilities:Required Qualifications:Additional Information: This is a full-time position . The role is based on-site in Gulberg 3, Lahore, and requires candidates to be available for evening shifts. Applicants must reside in Lahore to be eligible for consideration.Candidates who meet the outlined qualifications and are comfortable working evening hours are encouraged to apply.<ul><li>Understand ICD, CPT, and HCPCS codes assignments for accuracy in medical bills.</li><li>Review clinical documentation to ensure correct coding for insurance and billing purposes.</li><li>Maintain compliance with healthcare regulations and coding standards.</li><li>Work closely with healthcare providers to clarify any coding-related information when needed.</li><li>Certification as a CPC (Certified Professional Coder), CCS (Certified Coding Specialist), or an equivalent credential.</li><li>Strong understanding of medical terminology, anatomy, and disease processes.</li><li>Proven experience in medical coding, preferably within a hospital or clinical setting.</li><li>Exceptional attention to detail and strong organizational skills.</li></ul>Job Type: Full-timePay: Rs60,000.00 - Rs80,000.00 per monthApplication Question(s):<ul><li>What is your Location?</li></ul>Education:<ul><li>Bachelor's (Preferred)</li></ul>Experience:<ul><li>data entry : 1 year (Preferred)</li></ul>Work Location: In person

Medical Coder / Billing

CLINOVEX Clinical Research Solutions

<ul><li>TRAINING PROVIDED FOR FRESHERS</li><li>Review and assign appropriate codes for both Hospital billed services</li><li>Ensure accuracy of ICD-10-CM, CPT, HCPCS, and modifier usage per payer guidelines</li><li>Evaluate and resolve claim denials, including medical necessity and timely filing issues</li><li>Provide feedback on payer denials and assist with the appeal process when appropriate</li><li>Reference and interpret UB04, CMS-1500, EOBs, and RAs to support coding validation</li><li>Collaborate with internal teams and external partners to resolve coding discrepancies</li><li>Maintain up-to-date knowledge of industry standards, payer-specific rules, and coding regulations</li><li>Work independently and maintain productivity standards in an onsite setting</li><li>Use electronic health record (EHR) systems and documentation tools to access and update coding information</li><li>Refer to written training resources and coding references as needed</li><li>T</li><li>TRAINING WILL BE PROVIDED FOR FRESHERS</li><li>Certified Billing and Coding Specialist (CBCS) or AAPC Coder Certification or Training will be provided</li></ul><ul><li>Strong knowledge of ICD-10-CM, CPT, HCPCS, UB04, and CMS-1500 forms</li><li>Familiarity with Medicare, Medicaid, HMOs, PPOs, and managed care plan guidelines</li><li>Proficient in medical terminology, healthcare documentation, and coding best practices</li><li>Strong comprehension, problem-solving, and conflict resolution skills</li><li>Excellent verbal and written communication skills in English</li><li>Ability to work independently with minimal supervisionPreferred Skills:</li></ul><ul><li>Experience working in a fully remote coding or RCM environment</li><li>Prior involvement in denial resolution and payer appeals</li><li>Comfortable using multiple healthcare platforms and EHR systems</li><li>Ability to analyze coding patterns and identify billing trends</li></ul>Job Type: Full-timePay: &#8377;10,000.00 - &#8377;15,000.00 per monthEducation:<ul><li>Bachelor's (Preferred)</li></ul>Work Location: In person

MEDICAL CODING INTERN BSC/MSC/NURSING/PHARMA

Advocate Aurora Health

<div>Major Responsibilities:<ul><li>
Review assigned codes, which most accurately describe each documented diagnosis and/ or procedure according to established CPT, HCPCS, and ICD-10-CM coding guidelines along with modifier usage and medical terminology. Monitor all coding accuracy at various levels of detail and maintain coding quality as needed. Track coding issues and review coding inaccuracies to highlight areas of improvement. Report or resolve escalated issues as necessary.</li><li>
Responsible for reviewing Clinician documentation and billed codes for Medical Group physicians and non-physician clinicians. Review of medical records in collaboration with key stakeholders such as Internal Audit, Compliance, and Clinic Operations. Responsible for completing all certified coder quality reviews. Working in collaboration with Coding Production Leads and Supervisors.</li><li>
Follows the prospective and/or retrospective review plan to sample employed Clinician's medical record documentation in comparison to services selected for billing, based on best practice methodologies which will be presented and reviewed with Clinicians to provide feedback on proper coding and documentation practices.</li><li>
Follows the necessary schedules for team assignments of documentation/coding accuracy. Conducts required, timely reviews per the established Clinician Documentation Review Plan and generates summary reports for Professional Coding leadership and Provider Compliance Committee. Develops mechanisms to identify specific quality issues for each Clinician to allow for focused follow-up reviews to identify improvement/correction of those elements for which the Clinician has received an education.</li><li>
Ensures compliance with the system Clinician Documentation Review Plan escalation process for any Clinician who is not successful in meeting the minimum acceptable thresholds. Provides feedback when documentation issues are identified that need improvement. Conducts focused reviews requested by the Compliance department, clinic administration, and Professional Coding leadership. Utilizes monitoring tools or other applications to track and report the progress of the Clinician Documentation &amp; Coding Accuracy Plan and for the evaluation of coding quality standards.</li><li>
Identifies, evaluates and acts to resolve any barriers to meeting documentation standards. Provides education/feedback to the department Educators and Coding Liaisons. Maintains coding quality standardized reporting mechanisms. Provides standardized statistical reports of coding quality information to Professional Coding leadership and other appropriate parties.</li><li>
Identifies and trends coding quality issues/concerns. Recommends coding accuracy improvement strategies, including continued education and/or training plans. Provides feedback regarding coding guidelines, coding protocols/procedures, and system edits to continually improve coding processes and ultimately the overall coding quality program.</li><li>
Conducts scheduled and ad hoc coding quality reviews. Conducts regularly scheduled reviews of encounters where coding has been changed or deleted by Coding team members to ensure accuracy and provide education recommendations. Reviews abstracted and coded encounters for coding accuracy and completeness. Provides feedback on billing system edits as applicable.</li><li>
Provides results to Physician Coding leadership and education recommendations as needed. Collaborates with interdepartmental or cross-functional teams for assigned projects and provides departments with coding issues and updates to be shared with Clinicians.</li><li>
Utilizes chart review results to provide data-driven feedback to clinicians and management to improve coding accuracy and identify opportunities for improvement and re-training. Maintains up-to-date knowledge of Medicare, Medicaid, and other regulatory requirements pertaining to nationally accepted coding policies and standards.</li></ul> 
Licensure, Registration, and/or Certification Required:<ul><li>
Coding Associate (CCA) certification issued by the American Health Information Management Association (AHIMA), or</li><li>
Coding Specialist - Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA), or</li><li>
Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA), or</li><li>
Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA), or</li><li>
Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC), or</li><li>
Specialty Coding Professional (SCP) certification issued by the Board of Medical Specialty Coding and Compliance (BMSC), and</li><li>
Specialty Medical Coding Certification issued by the American Academy of Professional Coders (AAPC).</li></ul> 
Education Required:<ul><li>
Advanced training beyond High School that includes the completion of an accredited or approved program in Medical Coding Specialist.</li></ul> 
Experience Required:<ul><li>
Typically requires 5 years of experience in expert-level professional coding and at least 3 years of experience in the education of clinicians in physician revenue cycle processes, health information workflows, and medical record auditing experience.</li></ul> 
Knowledge, Skills &amp; Abilities Required:<ul><li>
Advanced knowledge of ICD, CPT, and HCPCS coding guidelines.</li><li>
Advanced knowledge of medical terminology, anatomy, and physiology.</li><li>
Advanced ability to identify coding quality issues/concerns and provide recommendations for improvement.</li><li>
Advanced ability to analyze trends and data and display them in a statistical reporting format.</li><li>
Advanced organization and communication (verbal and written) skills.</li><li>
Advanced ability to effectively train others through oral and/or written methods.</li><li>
Advanced organization, prioritization, and reading comprehension skills.</li><li>
Advanced analytical skills, with high attention to detail.</li><li>
Intermediate computer skills including the use of Microsoft Office, email, and exposure or experience with electronic coding systems or applications.</li><li>
Advanced knowledge of care delivery documentation systems and related medical record documents.</li><li>
Advanced interpersonal communication skills (oral and written) necessary to collaborate with Physicians, other clinicians, and Professional Coding Department team members and leadership.</li><li>
Ability to work independently and exercise independent judgment and decision-making.</li><li>
Ability to meet deadlines while working in a fast-paced environment.</li><li>
Ability to take initiative and work collaboratively with others.</li></ul> 
 
Physical Requirements and Working Conditions:<ul><li>
Exposed to normal office environment.</li><li>
Position requires travel which will result in exposure to road and weather hazards.</li><li>
Operates all equipment necessary to perform the job.</li></ul> 
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.</div>

Physician Coding Review Specialist

Provox Global Solutions

We are seeking a detail-oriented and highly organized Insurance Verification Specialist to join our team. As a key player in our healthcare organization, you will be responsible for verifying insurance information to ensure accurate billing and claims processing. If you have a strong background in insurance verification, attention to detail, and a commitment to ensuring a seamless experience for both patients and providers, we want to hear from you.Key Responsibilities:<ul><li>Review Scheduled Patients: Check the list of patients scheduled for the next day.</li><li>Prioritize Verification: Prioritize verification based on external factors that may impact the verification time, considering insurer processing times and appointment dates.</li><li>Complete PPO/HMO Forms: Fill out the PPO/HMO forms with information received from the clinic, patient/client, and the verification conducted with the insurance provider.</li><li>Database Entry: Store information in the designated database in a clear and legible manner.</li><li>Utilize Identification Methods: Use company-designated identification methods to confirm the patient's eligibility for medical center services.</li><li>Meet Verification Metrics: Adhere to verification compliance metrics, meeting both daily</li><li>Communication: Interact with patients to obtain additional insurance details or clarify information.</li><li>Problem Resolution: Investigate and resolve insurance-related issues, discrepancies, or challenges.</li><li>Customer Service: Provide excellent customer service to both internal and external stakeholders.</li></ul>Qualifications:<ul><li>Educational qualification Bachelor degree.</li><li>Proven experience in insurance verification within a healthcare setting.</li><li>Familiarity with medical terminology and coding.</li><li>Strong communication and interpersonal skills.</li><li>Detail-oriented with excellent organizational abilities.</li><li>Proficiency in using insurance verification software and electronic health record systems.</li></ul>Job Type: Full-timeApplication Question(s):<ul><li>Our office is located in Naval Anchorage, Islamabad. This is an on-site opportunity with shift timings from 6 PM to 3 AM. Are you comfortable with this shift arrangement?</li></ul>Experience:<ul><li>Verification of Benefits: 1 year (Required)</li><li>Dental Billing : 1 year (Required)</li></ul>Language:<ul><li>English (Required)</li></ul>Work Location: In person

Dental Billing Specialist

Quironsalud

Primary Responsibilities:<ul><li>Must have appropriate DRG knowledge and experience</li><li>The Coder must undertake a thorough review of applicable documentation to assess the documentation requirement and determine the appropriate ICD-10-CM and/or CPT-4/codes to be reported, in conjunction with the applicable version of Official Guidelines.</li><li>Analyzing and auditing of claims for completeness with relation to medical information and insurance coverage for services rendered.</li><li>Understand the individual client payer contracts so as be able to process claims in submission.</li><li>Be able to process claims either in OP or IP scenario</li><li>Analyze and communicate coding and billing issue of the provider to the supervisors.</li><li>Have complete knowledge of Coding &amp; billing guidelines of the provider and payer.</li><li>Researches, analyzes, recommends, and facilitates plan of action to correct discrepancies and prevent future coding errors.</li><li>To assist with documentation review and raise queries on completeness of EMR</li><li>Must also observe UAE code of ethics while assigning relevant code sets.</li><li>Preapproval and Precertification for claims requiring approval.</li><li>Making Cost estimates according to procedures</li><li>Monitoring and follow up on prior authorization for outpatient/inpatient services</li><li>Scanning of cases to identify lack of documentation by physician/ reports prior to submitting to payer</li><li>Contacting the payers/TPA for approval related matters. Communicates adequately with external parties.</li><li>Contacting the physician/nurses for further clarification to make the claim eligible for preapproval.</li><li>Identify and analyze problems, take action to resolve, apply sound judgment and take responsibility for their resolution</li><li>Inform and influence others by clear, concise expression of ideas and information in verbal and written as appropriate</li><li>Timely and meets deadlines.</li><li>Reporting trends related to preapproval to reporting TL /Supervisor</li></ul>Job Requirements:<ul><li>Bachelor in Life Sciences</li><li>Most relevant coding certification with updated membership to a body as accepted by the geographical governance area (AAPC or AHIMA).</li><li>Relevant experience of at least 1 year in medical coding.</li><li>Should at least have basic knowledge of Evaluation and Management services. Prior hands on experience would be an added advantage.</li><li>Experience in UAE coding will be an added advantage.</li></ul>Job Type: Full-time

Senior Insurance DRG Coder

eServMD Pvt. Ltd.

eServMD Pvt Ltd is a service provider company based in Islamabad Pakistan providing services to US-based companies and clients in the field of Electronic Medical Records (EMR), Medical Practice Management, Medical Billing, Real Estate, Accounts &amp; Finance.We are seeking experienced and detail-oriented A/R Specialists to join our team.Responsibilities:<ul><li>Work on CPT/ICD coding to ensure accurate and compliant billing practices.</li><li>Review patient bills for accuracy, completeness, and obtain any missing information.</li><li>Knowledge of insurance guidelines, especially Medicare and state Medicaid, to ensure proper billing procedures.</li><li>Follow up on unpaid claims within the standard billing cycle timeframe.</li><li>Check each insurance payment for accuracy and compliance with contract discounts.</li><li>Contact insurance companies regarding any discrepancies in payments, if necessary.</li><li>Identify and bill secondary or tertiary insurances.</li><li>Review all accounts for insurance or patient follow-up.</li><li>Answer patient or insurance telephone inquiries related to assigned accounts.</li><li>Communicate effectively with team members and clients.</li><li>Perform account receivables, denial management, and appeal management.</li><li>Maintain protocols and documentation for each performed task.</li><li>Assist with any other tasks as assigned by management.</li><li>Maintain strong verbal communication skills in English.</li></ul>Job Specification:<ul><li>Minimum 1-3 years of experience in Medical Billing.</li><li>Excellent working knowledge of EHRs and medical billing software such as CureMD, Kareo, ECW, Practice Fusion, MS Office, Web Fax (Metro Fax), Encoder pro, Payer Portals, and other related tools and software.</li><li>Strong knowledge of medical billing and coding practices.</li><li>Experience in denial management and appeals.</li><li>Proficient in handling authorization processes (pre, post, and retro).</li><li>Ability to conduct research and generate management reports.</li><li>Must be a team player and collaborate effectively with colleagues.</li><li>Strong verbal and written communication skills in English, including good typing speed.</li><li>Familiarity with infrastructure as code of conduct.</li><li>Excellent problem-solving and troubleshooting skills.</li><li>Experience in accounts receivable follow-up.</li><li>Denial management experience for multi-specialty groups.</li><li>Ability to handle insurance calling and retrieval of EOBs.</li><li>Efficient and fluent communication with external entities.</li><li>Familiarity with insurance account receivable processes.</li></ul>Job Type: Full-timeJob Type: Full-timeWork Location: In person

Medical Billing A/R Specialist

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