medical insurance coding specialist

Pandya Medical Center

<div>
 Culture and Values:
 
 
 At Pandya Medical Center, we believe in going above and beyond for every patient. Our team members are dedicated professionals who truly care about making a difference. We listen, understand, and treasure each personal story shared by our patients. Our commitment extends beyond our clinic walls, with active involvement in community health fairs and volunteering initiatives. We are a highly reputed medical practice in North Atlanta, offering strong growth opportunities and robust benefits for our employees. Be a part of our dynamic team and take your career to the next level with Pandya Medical Center.
 
 
 
 Job Summary
 
 
 
 The Medical Billing &amp; Coding Specialist assures accurate and complete coding information is collected and reported to private insurance and Medicare to help complete the revenue cycle. The specialist will scrub encounters for accurate coding prior to claim creation, assure correct modifiers and ICD10 diagnosis codes are allocated to each CPT code, ensure timely claim submissions and follow-up on claim denials. The candidate should have knowledge of insurance regulations and medical coding with the goal of maximizing accurate third-party billing and minimizing denials. The position is full time with competitive salary, and strong benefits including PTO, health insurance and 401k match. The ideal candidate will be located in Georgia and able to be present at our administrative office in the Johns Creek area. If you are an experienced and motivated Medical Billing &amp; Coding Specialist who wants to grow with a thriving medical practice, we encourage you to apply today and join our dedicated team at Pandya Medical Center.
 
 
 Duties and Responsibilities
 
 
 Accurate and timely submission of medical claims to insurance companies and other payers
 
 
 Review and analyze medical records to ensure appropriate coding of diagnoses and procedures
 
 
 Document for providers and management any insufficient or unclear information on claims
 
 
 Assign or reassign CPT, HCPCS, and ICD-10-CM codes as needed
 
 
 Follow up on unpaid claims and initiate appeals for denied claims within 30 days of submission.
 
 
 Track the progress of claims through the clearinghouse and promptly address any issues
 
 
 Resolve patient billing issues and questions via phone and email in a timely fashion
 
 
 Stay updated on healthcare regulations, medical terminology, and coding practices
 
 
 Follow HIPAA guidelines when accessing and sharing patient information
 
 
 Additional job related duties or projects as needed
 
 
 
 Qualifications And Skills
 
 
 
 Minimum of 3 years&rsquo; experience with medical billing or revenue cycle in a medical setting
 
 
 Certified Professional Coder thru AAPC or a Certified Coding Specialist thru AHIMA - Required
 
 
 Knowledge of insurance guidelines including HMO/PPO, Medicare and other payers&rsquo; requirements and systems
 
 
 Knowledge of CPT, ICD-10, HCPCS Coding and utilization of modifiers
 
 
 Knowledge of medical billing rules, modifiers, and strong understanding of EOBs and ERAs
 
 
 Competent in computer skills, Microsoft Office or similar software
 
 
 Experience with AthenaHealth EHR is preferred or other similar EHR systems such as Epic, or eClinicalWorks
 
 
 Experience with Family Practice and Primary Care outpatient billing (Preferred)
 
 
 Exceptional Customer Service skills for interacting with patients regarding medical claims and payments
 
 
 Self-motivated with ability to multi-task, prioritize work in a fast-paced, team environment
 
 
 Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
 
 
 Strong understanding of patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
 
 
 Salary range: $20.00 - 24.00/hr
 
 
 Benefit Eligibility
 
 
 Aetna Health insurance
 
 
 Aetna Dental and Vision plans
 
 
 Aflac Supplemental insurance plans
 
 
 401K match plan with up to 4% by Pandya Medical Center
 
 
 Paid Time Off
</div>

Medical Billing & Coding Specialist

ExamWorks

<div>
 
 Exam Works is looking for a Medical Coding Specialist to join our team remotely!
 
 
 
 <ul>
 <li>
 Must possess current coding certification in CPC. CPMA certification &amp; Certified Life Care Planner certification preferred.
 
 
 </li>
 </ul>
 The
 
 Medical Coding Specialist
 
 (Internally called a Coding Specialist) is responsible to create and write reports based on medical records and appropriate guideline criteria. This position utilizes the system database to determine usual and customary and/or state fee schedule allowances and this position is responsible for analyzing provider billing for proper coding and billing guidelines across all provider types and ensures reviews are completed with highest quality and integrity and that all work is in full compliance with client contractual agreements, regulatory agency standards and/or federal and state mandates.
 
 
 Schedule for this role is:
 
 Monday - Friday 8am-5pm EST
 
 
 
 
 Essential Job Functions
 
 
 
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 Receive and input client and examinee data in the system database.
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 Sort and verify each claim.
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 Process and review each claim and address all necessary modifications manually. Contact Client as needed
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 Perform quality assurance on every case prior to completion.
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 Ensure all medical records and reports are properly documented and saved in the appropriate location and available for audit at all times.
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 Process client invoicing in accordance with the client&rsquo;s fee schedule.
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 Handle and responds promptly to incoming calls, emails or faxes from clients requesting report status and/or information.
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 Provide notification to the Supervisor of any provider appeals and follow directions as given to resolve the claim.
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 Provide testimony in court as to the content of prepared reports, as required. Travel as necessary.
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 Ensure all practices are carried out in accordance with HIPAA compliance practices, state and federal safety standards and legal regulations.
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 Perform quality assurance on various coding related reviews.
 </li>
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 Perform other duties as assigned.
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 
 Education and/or Experience
 
 
 
 <ul>
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 High school diploma or equivalent required.
 </li>
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 Minimum one year medical billing experience; or equivalent combination of education and experience required.
 
 
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 </ul>
 
 Certificates, Licenses, Registrations
 
 
 
 
 Must Possess Current Coding Certification In
 
 
 
 <ul>
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 OASIS, RAC-CT, CCS, CPC, RHIT or RHIA. CPMA certification preferred.
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 <ul>
 <li>
 Must have minimum of one year medical billing experience; or equivalent combination of education and experience required.
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 Must have a full understanding of aspects of medical billing.
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 Must demonstrate understanding of the various types of medical billings and ability to identify which system database should be used.
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 Must be able to cross reference different types of billings to ensure consistency in the review process.
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 Must possess knowledge of standard fee schedule review, UC&amp;R review, drug and supply charges, rarity, utilization review, CPT guidelines, ICD 10, bundling/unbundling, duplicate billing and CMS reimbursement guidelines.
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 Must possess complete knowledge of general computer, fax, copier, scanner, and telephone.
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 Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
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 Must have a full understanding of HIPAA regulations and compliance.
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 Must be a qualified typist with a minimum of 35 W.P.M.
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 Ability to follow instructions and respond to managements&rsquo; directions accurately.
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 Ability to work independently, prioritize work activities and use time efficiently.
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 Must be able to maintain confidentiality.
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 Must be able to demonstrate and promote a positive team -oriented environment.
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 Must be able to stay focused and concentrate under normal or heavy distractions.
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 Must be able to work well under pressure and or stressful conditions.
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 Must possess the ability to manage change, delays, or unexpected events appropriately.
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 Ability to follow all company policies and procedures in effect at time of hire and as they may change or be added from time to time.
 
 
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 </ul>
 
 ExamWorks
 
 is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages.
 
 
 
 ExamWorks, LLC
 
 is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.
 
 
 
 Equal Opportunity Employer - Minorities/Females/Disabled/Veterans
 
 
 
 
 
 ExamWorks offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.
 
 
 
 
 TAGS
 
 
 CPC, CPMA, Medical Billing, Medical Billing Specialist
</div>

Medical Coding Specialist (31620)

EPMed, PA

Job Overview We are seeking a highly motivated and detail-oriented Medical Billing and Coding Specialist to join our healthcare team. In this role, you will be responsible for accurately coding medical procedures and diagnoses, managing billing processes, and ensuring timely reimbursement from insurance providers. Your expertise will help streamline revenue cycle management, improve patient records accuracy, and support the overall efficiency of our healthcare operations. This position offers an exciting opportunity to apply your medical coding skills in a dynamic environment dedicated to delivering exceptional patient care.Responsibilities<ul><li>Review and interpret medical records to assign appropriate ICD-9, ICD-10, CPT (Current Procedural Terminology), and DRG (Diagnosis-Related Group) codes for billing purposes</li><li>Ensure all medical billing submissions are accurate, complete, and compliant with current regulations and payer policies</li><li>Manage the entire billing cycle&mdash;from patient account creation to follow-up on unpaid claims&mdash;using Electronic Medical Record (EMR) and Electronic Health Record (EHR) systems</li><li>Collaborate with healthcare providers to clarify documentation or coding discrepancies to optimize reimbursement</li><li>Conduct medical collections by following up on unpaid claims and resolving billing issues efficiently</li><li>Maintain detailed records of medical procedures, diagnoses, and billing activities in accordance with privacy laws and organizational standards</li><li>Stay updated on changes in medical coding standards, insurance policies, and regulatory requirements to ensure ongoing compliance</li></ul>Experience<ul><li>Proven experience in medical billing and coding within a healthcare setting, preferably with exposure to hospital or outpatient environments</li><li>Strong knowledge of ICD-9, ICD-10, CPT coding systems, as well as DRG classifications for inpatient stays</li><li>Familiarity with medical terminology, medical records management, and documentation standards</li><li>Experience working with EMR/EHR systems for billing and record-keeping purposes</li><li>Ability to interpret complex medical data accurately and translate it into appropriate codes for billing purposes</li><li>Excellent attention to detail with strong organizational skills to manage multiple claims simultaneously</li><li>Prior experience in medical collections or revenue cycle management is a plus</li></ul>Join us in this vital role where your expertise directly impacts patient care delivery while supporting the financial health of our organization. We value proactive professionals who thrive in fast-paced environments and are committed to accuracy, compliance, and continuous learning.Job Type: Full-timePay: $15.00 - $17.00 per hourBenefits:<ul><li>401(k)</li><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li></ul>Work Location: In person

Medical Billing and Coding Specialist

Drs Rubinstein & Ducoff Inc

Job Overview We are seeking a proactive and detail-oriented Medical Insurance Authorization Specialist to join our healthcare team. In this vital role, you will be responsible for managing insurance authorizations, verifying coverage, and ensuring timely approval for patient services. Your expertise will help streamline the authorization process, reduce delays, and enhance patient care experiences. This position offers an exciting opportunity to work within a dynamic medical environment, utilizing your knowledge of managed care and medical coding to facilitate seamless insurance interactions.Responsibilities<ul><li>Obtain prior authorization and pre-certification from insurance providers for oral sleep appliances and follow up appointments</li><li>Verify patient insurance coverage and benefits accurately using insurance portals and verification systems.</li><li>Review medical records, documentation, and clinical notes to support authorization requests in compliance with HIPAA regulations.</li><li>Utilize CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding systems to prepare accurate documentation for insurance submissions.</li><li>Communicate effectively with healthcare providers, insurance companies, and patients to resolve authorization issues promptly.</li><li>Maintain detailed records of all authorization requests, approvals, denials, and follow-up actions in the medical records system.</li><li>Stay updated on managed care policies, insurance guidelines, and coding changes to ensure compliance and efficiency in the authorization process.</li></ul>Experience<ul><li>Prior experience working in a medical office setting or dental office environment is highly preferred.</li><li>Strong knowledge of managed care processes, insurance verification procedures, and medical billing practices.</li><li>Familiarity with HIPAA regulations to ensure patient confidentiality during all interactions.</li><li>Proficiency in medical terminology, medical records management, and medical coding including CPT, ICD-9, ICD-10, and ICD coding systems.</li><li>Experience with insurance authorization workflows within a healthcare or dental office setting is advantageous.</li><li>Excellent organizational skills with the ability to handle multiple tasks efficiently while maintaining attention to detail.</li><li>Office experience demonstrating proficiency with electronic health records (EHR) systems or similar software. Join us in making a difference by ensuring patients receive the care they need without unnecessary delays! We value energetic professionals who are eager to contribute their expertise in managed care and medical coding while providing exceptional service within a collaborative team environment.</li></ul>Pay: $24.23 - $29.18 per hourWork Location: In person

Medical Insurance Authorization Specialist

<div>
 
 
 WHO WE ARE:
 
 
 
 
 AC3 was founded by a group of oncologists who built solutions to optimize their own practices. Now, we give specialty health practices the power to make decisions with better data. Our mission is to help them thrive through people, purposeful technology, and collaboration. The work we do empowers healthcare practitioners and their teams to provide the highest quality of care in a sustainable way.&nbsp;That&rsquo;s&nbsp;what motivates&nbsp;us.
 
 
 
 We&rsquo;re looking for passionate, driven innovators to join our mission. If you thrive on challenge, love taking action, and get up every day ready to make a difference, apply now. Learn more at www.ac3health.com.&nbsp;
 
 
 
 
 COMPANY MISSION:&nbsp;
 
 
 
 To help specialty practices thrive.
 
 
 
 &nbsp;
 
 POSITION SUMMARY:&nbsp;
 
 The Certified Medical Coder is responsible for ensuring all diagnoses and procedures are coded appropriately for all claims. This position will need to remain current on coding and billing regulations as well as any CPT, ICD10 or HCPCS updates. This role supports the department to design the capture of associated coding and billing various medical specialties. They will work cooperatively as a team with revenue cycle, client practices and management associates. He/she will provide courteous and professional assistance with coding questions from physicians, clinical team members and other departments. The successful candidate for this role must have exceptional computer, communication, and organizational skills. This position may require onsite training at our office in South Bend, IN, as well as attendance of department and organizational meetings.&nbsp;
 
 
 
 
 ESSENTIAL FUNCTIONS AND JOB RESPONSIBILITIES
 
 
 
 
 Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
 
 
 <ul>
 
 <li>
 Responsible for billing daily charges by designated site and matching insurance carriers to the specific billing requirements for Medicare, Medicaid, Blue Cross Blue Shield and Commercial carriers.
 </li>
 
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 Capable and knowledgeable on billing charges for chemotherapy and administration codes, E/M office and hospital charges in a timely manner.
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 Accessing and reading operative and pathology reports from multiple hospital systems, coding the correct ICD-10, CPT, and modifiers, and billing the charges.
 </li>
 
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 Retrieves, reads, and applies updated LCD/NCD policies when necessary.
 </li>
 
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 Identifies and reports any fraud, waste, or abuse concerns.
 </li>
 
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 Reviews patients&rsquo; charts and applies appropriate medical codes.
 </li>
 
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 Works with the clients&rsquo; physician team to get any missing information or signatures to bill charges.
 </li>
 
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 Ensures timely filing of claims per SOP guides.
 </li>
 
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 Works together as a team with the whole department.
 </li>
 
 <li>
 Maintains the practices and principles set forth by AC3 leadership with a strong commitment to service, excellence and quality.
 </li>
 
 <li>
 Maintains professional behavior, confidentiality, and discretion at all times, along with the ability to work with all levels of staff with a confident and professional demeanor.
 </li>
 
 <li>
 Follows HIPPA rules and regulations.
 </li>
 
 </ul>
 
 
 
 &nbsp;
 
 
 POSITION REQUIREMENTS
 
 
 
 <ul>
 
 <li>
 High school diploma or equivalent (GED). &nbsp;One or more of the following credentials is required: CPC (Certified Professional Coder); CHONC (Certified Hematology Oncology Coder, through AAPC); CCS (Certified Coding Specialist, through AHIMA); or CCS-P (Certified Coding Specialist &ndash; Physician based, through AHIMA).
 </li>
 
 <li>
 Demonstrates knowledge and competence in CPT, ICD-10, POS and modifiers.
 </li>
 
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 Accurately maintains and adheres to all safety rules and regulations.
 </li>
 
 <li>
 Accurately code/bill charges to the best of your ability without fraudulence.&nbsp;
 </li>
 
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 Knowledge of anatomy and medical terminology.
 </li>
 
 <li>
 Proficient in Microsoft Office preferred. &nbsp;Working knowledge/experience in electronic medical records and/ or other medical software if applicable.
 </li>
 
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 Excellent communication and organizational skills with the ability to work in a fast paced environment; prioritize tasks and workloads.
 </li>
 
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 Performs other duties as assigned.
 </li>
 
 <li>
 This is a remote position with the expectation of travel to meet the needs of the position. Work is completed in a general office environment, sedentary in nature but may require standing and walking for up to 10% of the time. The work environment is favorable with adequate lighting and temperature, and no hazardous or unpleasant conditions caused by noise, dust, etc. &nbsp;Must be able to operate standard office equipment and keyboards.&nbsp;
 </li>
 
 </ul>
 
 
 
 WORK LOCATION:
 
 
 &nbsp;This is a hybrid position; meaning, there will be required onsite training and a combination of a remote and onsite work. The ideal candidate will reside within a 30-mile radius of the office located in South Bend, IN.
 
 
 
 
 Work is completed in a general office environment, sedentary in nature but may require standing and walking for up to 10% of the time. The work environment is favorable with adequate lighting and temperature, and no hazardous or unpleasant conditions caused by noise, dust, etc. &nbsp;Must be able to operate standard office equipment and keyboards.&nbsp;
 
 
 
 
 Why Work at AC3?
 
 
 
 
 When you become an AC3 Team member, you can expect ongoing training, support, and a work culture like no other. We offer our Full-Time Team Members medical, dental and vision health and wellness benefits, along with employer paid life insurance, long and short-term disability policies. &nbsp;Because our team&rsquo;s health and wellness are our priority, we start new hires off with an above average paid time out plan and offer a comprehensive wellness program, including onsite biometrics and ongoing mental and physical wellness support. We also provide all Team Members with access to company sponsored financial wellness counselors, employee assistance services and the opportunity to enroll in our company-matched, 401k plan.
 
 
 
 
 Come join our Winning Team!
 
 
</div>

Medical Coding Specialist - Hybrid

Signature Healthcare

<div><div><div><div><div>POSITION SUMMARY:
Under the general direction of the Coding Compliance Manager the Outpatient Coding Specialist is responsible for coding and abstracting services for the full range of hospital services. Reviews diagnosis and diagnostic information and codes and abstracts diagnoses and/or surgical procedures outpatient services, and/or emergency room records using ICD 10 CM and CPT 4 coding classification systems. Ensures ethical and accurate coding in accordance with all regulatory requirements and AHIMA Standards of Ethical Coding.</div> 
</div>
</div></div> 
Location: Signature Healthcare &middot; Health Information Management 
Schedule: Full Time 40 Hours only, Days 1st Shift, flexible</div>

Outpatient Coding Specialist

FRENCH CLINICS MEDICAL AND DENTAL LLC

We are seeking a skilled and experienced Female Insurance Coder to join our Dental Center in Abu Dhabi. As a key member of our team, you will play a crucial role in ensuring accurate and efficient medical coding and insurance processing.Responsibilities:- Pre-Approval &amp; Authorization - Verifying documentation for accuracy and completeness.- Assigning appropriate codes to diagnoses and procedures for dental services. - Collaborating with healthcare providers to clarify information and resolve coding issues. - Ensuring compliance with coding guidelines and regulations. - Proficient in English, both written and verbal. -Detail-oriented with strong analytical and problem-solving skills.Salary will discuss upon the interviewNotes: Only with experience in Dental ClinicsJob Type: Full-timePay: AED3,000.00 - AED3,500.00 per monthWork Location: In person

Insurance Coder (Experience in Dental field) in Abu Dhabi

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