CERTIFIED MEDICAL CODER

ADP, Inc.; Merrillville (IN); On-site; USD 55,000 - 75,000; Full time

Job summary

Bone & Joint Specialist is seeking a Certified Medical Coder to translate physician notes into ICD-10 and CPT codes for billing, ensuring accurate coding and timely reimbursement while maintaining compliance with HIPAA.

You will review medical records, verify insurance coverage, communicate with providers to resolve discrepancies, and stay current with coding guidelines and regulations to support accurate charges.

Qualifications

• Certified Professional Coder Certification is required.
• Must stay current with coding guidelines and regulations.
• Experience with medical billing or coding is expected.
• Strong communication with providers and billing team.
• HIPAA, State and Federal regulations knowledge.

Responsibilities

• Review and analyze medical records to ensure accurate billing.
• Verify patient insurance coverage and process claims for reimbursement.
• Communicate with healthcare providers to resolve billing discrepancies.
• Maintain up-to-date knowledge of coding guidelines and regulations.
• Collaborate with billing team to ensure timely and accurate billing.
• Audit charges and ensure correct posting of charges.
• Assist with external and internal audits as requested.

Skills

Attention to detail

Multitasking

Communication skills

Independent work

Education

Certified Professional Coder Certification

Tools

Electronic Medical Records Software

Excel

Outlook

Word

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

CERTIFIED MEDICAL CODER

3 days ago Requisition ID: 1023

Bone & Joint Specialist is looking for a Certified Medical Coder. In position you will be responsible for accurately translating medical diagnoses, procedures and services from physician notes into standardized codes (like ICD-10, CPT) for billing insurance, ensuring compliance, resolving claim denials, communicating with providers for clarification and facilitating timely reimbursement for healthcare services.

DUTIES AND RESPONSIBILITIES:

• Review and analyze medical records and patient information to ensure accurate billing.
• Verify patient insurance coverage and process claims for reimbursement.
• Communicate with healthcare providers to resolve any billing discrepancies or issues.
• Maintain up-to-date knowledge of coding guidelines and regulations.
• Collaborate with other members of the billing team to ensure timely and accurate billing.
• Review patient documents for accuracy to include but not limited to office visits, surgical, and non-surgical procedures.
• Ensure proper coding on provider documentation.
• Verify that all codes are current and active.
• Report missing and/or incomplete documentation to provider and/or clinical staff.
• Meet daily coding production expectations.
• Understand coding and reimbursement regulations and recognize the order in which services are billed to ensure maximum reimbursement by reading various coding and insurance newsletters and websites.
• Monitor, make updates and changes to fee schedule.
• Accurately post services based on global services data by applying NCCI edits, AAOC, NASS and ASSH Global Guidelines for all applicable insurance carriers.
• Serve as a resource regarding insurance resolutions and coding questions.
• Communicate changes and updates in coding requirements from insurance carriers to supervisor.
• Post daily charges and correct posting errors in practice management system.
• Assist with external and / or internal audits as requested.
• Review and make corrections based on the Missing Encounter Report.
• Audit charges provided by hospitals/surgical centers to capture all charges for posting.
• Complete annual education courses as required.
• Follow HIPAA, State and Federal regulations.
• Performs other related duties as assigned by management.

QUALIFICATIONS:

• Certified Professional Coder Certification (Required)
• Keeps coding certification current and earn yearly CEU’s to stay certified.
• Computer skills required: Electronic Medical Records Software; Spreadsheet Software (Excel); Word Processing Software (Word); Electronic Mail Software (Outlook);
• Other skills required:
  • Proficiency in ICD-9 and ICD-10 coding systems.
  • Previous experience in medical billing or coding is required.
  • Experience in appeals preferred.
  • Familiarity with DRG (Diagnosis Related Group) coding is preferred.
  • Excellent customer service skills both over the phone and by email.
  • Exceptional professionally written communication skills.
  • Strong research and organizational skills.
  • Detail-oriented with the ability to multi-task.
  • Ability to work independently and prioritize tasks effectively.