Job Description

This role is well suited for someone with a medical billing/coding background who is comfortable reviewing documentation, coding accurately, submitting high volumes of professional claims, and resolving billing issues while working both independently and collaboratively.

Responsibilities

Primary Responsibilities

• Review, manage and submit 75-100 CMS-1500 professional claims each day

• Assign accurate procedure and diagnosis codes

• Verify claim accuracy before submission

• Review medical records to determine appropriate ICD-10 and CPT codes

• Coordinate with other departments to obtain missing documentation

• Resolve claim rejections and make claim corrections

• Collaborate with revenue cycle teams to understand payer-specific billing guidelines and state insurance requirements

Qualifications

Key Qualifications

• Certificate or diploma from an accredited medical billing/coding program

• Professional coding certification (required)

• Knowledge of ICD-10 and CPT coding

• Strong attention to detail and accuracy

• Ability to multitask and prioritize work

• Strong analytical and comprehension skills

• Excellent verbal and written communication

• Intermediate proficiency in Microsoft Excel

• Work independently while maintaining timely communication with management

• Positive attitude and ability to work collaboratively

• Ability to consistently meet deadlines

Preferred Experience

• Medical billing and coding experience with CMS-1500 professional claims

• Knowledge of insurance policies and reimbursement processes

• Experience with out-of-network medical billing

Skills That Would Make a Strong Candidate

• Medical billing and coding

• ICD-10-CM and CPT coding

• Revenue cycle management

• Insurance verification and payer policies

• Claim denial and rejection resolution

• Medical records review

• Microsoft Excel

• Time management

• Attention to detail

• Communication and teamwork

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