What are the responsibilities and job description for the Dermatology Biller & Coder position at DEHESA DERMATOLOGY INC?
Description:
The Dermatology Medical Biller & Coder is responsible for accurately coding clinical services, submitting claims, posting payments, and ensuring timely reimbursement. This role plays a critical part in optimizing revenue cycle performance while maintaining compliance with payer guidelines, including Medicare and commercial insurance plans.
Requirements:- Assign accurate CPT, ICD-10, and HCPCS codes for dermatology services
- Review provider documentation to ensure coding accuracy and completeness
- Apply appropriate modifiers (e.g., -25, -59, -LT/RT)
- Ensure compliance with NCCI edits and payer-specific policies
- Identify documentation gaps and communicate with providers
- Enter charges into the practice management system (e.g., EMA)
- Verify services align with documentation and scheduled visit type
- Ensure correct provider, location, and insurance selection
- Prepare and submit clean claims to insurance payers
- Review and correct claim rejections or front-end edits
- Monitor claim status and ensure timely filing
- Post insurance payments (ERA/EOB) and patient payments
- Apply contractual adjustments accurately
- Identify underpayments and discrepancies
- Work denied or unpaid claims
- Investigate denials (authorization, medical necessity, coding errors)
- Submit appeals and corrected claims as needed
- Follow up with payers to ensure reimbursement
- Maintain compliance with:
- CMS (Medicare) guidelines
- Commercial payer policies
- Participate in internal audits to ensure coding accuracy
- Stay updated on coding changes and dermatology billing updates
Dermatology Biller Preferred