Billing & Coding Specialist Revenue Cycle Team

Revive Orthopedics; Lithia Springs (GA); Hybrid; USD 32,000 - 47,000; Full time

Job summary

Revive Orthopedics in Lithia Springs, GA is seeking a Billing & Coding Specialist to expertly assign ICD-10-CM, CPT, and HCPCS codes and manage the claim lifecycle from charge entry through payment posting. You will collaborate with physicians, schedulers, and front office staff to maximize clean claim rates, reduce denials, and ensure compliant reimbursement, with remote/hybrid work and onsite training.

Candidates should have 2+ years of medical billing and coding in a physician practice, and

Qualifications

• High school diploma or equivalent
• 2+ years of medical billing and coding experience in a physician practice
• Working knowledge of CPT, ICD-10-CM, HCPCS, and modifier usage
• Experience with payer rules, EOBs/ERAs, and denial management
• Proficiency with practice management/EHR system and Microsoft Excel
• Strong attention to detail, organization, and communication skills

Responsibilities

• Review clinic notes, operative reports, and procedure documentation to assign accurate ICD-10-CM, CPT, and HCPCS codes.
• Apply appropriate modifiers and global period rules.
• Code orthopedic services including E/M visits, fracture care, joint injections, DME dispensing, in-office procedures, imaging, and surgical cases.
• Ensure documentation supports medical necessity and coding level; query providers when documentation is incomplete or unclear.
• Stay current on CPT/ICD-10 updates, NCCI edits, and payer-specific coding policies.
• Enter charges and submit claims accurately and within timely filing limits.
• Review and resolve claim scrubbing edits and rejections before submission.
• Verify insurance eligibility, authorizations, and referrals as needed for surgical and high-cost services.
• Bill for implants, bracing, DME, and ancillary services per payer requirements.
• Maintain audit documentation.
• Work denials and underpayments, prepare appeals, and track outcomes.
• Follow up on unpaid claims with commercial payers, Medicare, Medicaid, workers' compensation, and auto/liability carriers.
• Post payments, adjustments, and ERAs/EOBs, resolving discrepancies.
• Identify denial trends and recommend process or documentation improvements.
• Respond to patient billing inquiries professionally and in a timely manner.
• Set up payment plans and assist with financial assistance processes per policy
• Coordinate with front desk and clinical staff to resolve registration, authorization, and documentation issues
• Adhere to HIPAA, Medicare/CMS regulations, and internal compliance policies.
• Participate in coding audits and implement corrective actions.
• Meet established productivity, accuracy, and A/R targets.

Skills

Analytical thinker

Self-motivated

Collaborative team player

Confidentiality

Attention to detail

Communication skills

Education

High school diploma or equivalent

CPC/CCS-P or equivalent certification (preferred)

Tools

Practice management/EHR system

Microsoft Excel

Job description

Position: Billing & Coding Specialist Revenue Cycle Team

Department: Revenue Cycle Management

Reports to: Revenue Cycle Director

Position Summary

The Billing & Coding Specialist is responsible for accurately assigning diagnosis and procedure codes for orthopedic services and managing the claim lifecycle from charge entry through payment posting and follow-up. This role works closely with providers, surgery schedulers, prior authorization staff, and front office teams to maximize clean claim rates, reduce denials, and support compliant, timely reimbursement.

Key Responsibilities

Coding

• Review clinic notes, operative reports, and procedure documentation to assign accurate ICD-10-CM, CPT, and HCPCS codes.


• Apply appropriate modifiers (e.g., -RT/-LT, -50, -51, -59, -62, -78, -79, -24, -25, -57) and global period rules.


• Code orthopedic services including E/M visits, fracture care, joint injections, DME dispensing, in-office procedures, imaging, and surgical cases.


• Ensure documentation supports medical necessity and coding level; query providers when documentation is incomplete or unclear.


• Stay current on CPT/ICD-10 updates, NCCI edits, and payer-specific coding policies.

Billing & Claims Management

• Enter charges and submit claims accurately and within timely filing limits.


• Review and resolve claim scrubber edits and rejections before submission.


• Verify insurance eligibility, authorizations, and referrals as needed for surgical and high-cost services.


• Bill for implants, bracing, DME, and ancillary services per payer requirements.


• Maintain audit documentation.

Denials, Follow-Up & Payment Posting

• Work denials and underpayments, prepare appeals, and track outcomes in a timely manner.


• Follow up on unpaid claims with commercial payers, Medicare, Medicaid, workers' compensation, and auto/liability carriers.


• Post payments, adjustments, and ERAs/EOBs, resolving any discrepancies.


• Identify denial trends and recommend process or documentation improvements.

Patient Accounts & Communication

• Respond to patient billing inquiries professionally and in a timely manner.


• Set up payment plans and assist with financial assistance processes per policy


• Coordinate with front desk and clinical staff to resolve registration, authorization, and documentation issues

Compliance & Quality

• Adhere to HIPAA, Medicare/CMS regulations, and internal compliance policies.


• Participate in coding audits and implement corrective actions.


• Meet established productivity, accuracy, and A/R targets.

Qualifications

Required

• High school diploma or equivalent


• 2+ years of medical billing and coding experience in a physician practice


• Working knowledge of CPT, ICD-10-CM, HCPCS, and modifier usage


• Experience with payer rules, EOBs/ERAs, and denial management


• Proficiency with practice management/EHR system and Microsoft Excel


• Strong attention to detail, organization, and communication skills

Preferred

• Active CPC, CCS-P, or equivalent certification (AAPC or AHIMA).


• Orthopedic or surgical specialty billing/coding experience.


• Experience with workers' compensation and auto/liability billing.


• Familiarity with global surgical packages, implant billing, and DME.


• Experience with [EHR/PM system, e.g., athenahealth].

Skills & Competencies

• Analytical thinker who can interpret clinical documentation and payer policies.


• Self-motivated, able to manage a high-volume workload and meet deadlines.


• Collaborative team player with strong provider and cross-department communication.


• Commitment to confidentiality, accuracy, and compliance.

Work Environment

• Remote/Hybrid position (onboarding will be onsite at the Lithia Springs Office), traveling to Lithia Springs as needed for training or leadership meetings.


• Extended periods of computer work.


• Standard hours Monday–Friday,


• High volume workloads with deadlines.