Medical Coding & Billing Specialist

A Medical Coding and Billing Specialist is responsible for reviewing medical records assigning accurate medical codes to diagnoses and procedures preparing and submitting insurance claims and ensuring timely reimbursement for healthcare services. This professional serves as a link between healthcare providers patients and insurance companies by ensuring that medical services are properly documented coded billed and processed in accordance with applicable healthcare regulations and insurance requirements. Key responsibilities include reviewing patient records for accuracy and completeness assigning appropriate ICD-10-CM CPT and HCPCS codes submitting insurance claims verifying patient insurance coverage investigating claim denials and resolving billing discrepancies. The specialist also maintains accurate billing records follows up on outstanding claims assists patients with billing inquiries and ensures compliance with healthcare coding standards payer policies and patient privacy regulations. Key Responsibilities: Review medical records and clinical documentation to identify diagnoses procedures and services accurate diagnostic and procedural codes using ICD-10-CM CPT and HCPCS coding review and submit medical claims to insurance companies and other patient insurance eligibility coverage and claim rejections and denials identify errors and submit corrected claims or appeals as patient invoices payments and billing up on outstanding claims and unpaid balances to support timely with healthcare providers insurance companies and patients to resolve billing accurate patient billing records and compliance with applicable healthcare regulations coding guidelines payer requirements and privacy Skills and Qualifications: Knowledge of medical terminology anatomy and healthcare with ICD-10-CM CPT and HCPCS coding of medical billing procedures insurance claims and reimbursement to detail and strong analytical and organizational in electronic health records (EHRs) and medical billing communication problem-solving and time-management of patient confidentiality and applicable healthcare privacy to identify coding errors investigate claim denials and resolve billing issues efficiently.