Billing and Coding Specialist

MPOWERHealth; West Conshohocken (PA); On-site; USD 45,000 - 65,000; Full time

Job summary

MPOWERHealth in Pennsylvania is seeking a CPC-certified medical billing/coding specialist to review, code, and submit a high volume of CMS-1500 professional claims. Responsibilities include assigning accurate ICD-10 and CPT codes, verifying claim accuracy before submission, and coordinating with other departments to obtain missing documentation.

The role requires excellent communication, meticulous attention to detail, and the ability to work independently while meeting deadlines in a fast-paced

Qualifications

• Must hold CPC 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.
• Excellent verbal and written communication.
• Intermediate Excel proficiency.
• Ability to work independently and meet deadlines.

Responsibilities

• Review, manage and submit 75–100 CMS-1500 professional claims daily.
• Assign accurate ICD-10 and CPT codes.
• Verify claim accuracy before submission.
• Review medical records to determine correct ICD-10 and CPT codes.
• Coordinate with other departments to obtain missing documentation.
• Resolve claim rejections and perform necessary corrections.
• Collaborate with revenue cycle teams to follow payer guidelines and state requirements.

Skills

CMS-1500 expertise

ICD-10 coding

CPT coding

Attention to detail

Communication skills

Multitasking

Excel

Education

CPC certificate or diploma

Tools

Microsoft Excel

Job description

MUST HAVE CPC CERTIFICATE\" Position is not remote

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.

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.

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.