Medical Biller and Coder

About Us

Grove Park Pharmacy Medical Clinic is a growing, patient-focused healthcare clinic located inside Grove Park Pharmacy in Orangeburg, SC. We provide primary care, acute care, wellness services, DOT physicals, aesthetics, and preventative healthcare to patients throughout the community. We are seeking a detail-oriented and experienced Medical Biller & Coder to join our team and help ensure accurate claim submission, timely reimbursement, and compliance with billing regulations.

Position Summary

The Medical Biller & Coder is responsible for accurately coding medical services, submitting insurance claims, following up on unpaid claims, resolving denials, posting payments, and ensuring compliance with payer and regulatory requirements. This position plays a critical role in maximizing revenue cycle performance while maintaining excellent patient service.

Essential Duties & Responsibilities

Medical Coding

• Review provider documentation for accuracy and completeness.
• Assign appropriate ICD-10, CPT, and HCPCS codes.
• Ensure coding complies with Medicare, Medicaid, and commercial insurance guidelines.
• Identify and correct coding discrepancies prior to claim submission.

Medical Billing

• Prepare and submit electronic insurance claims.
• Verify patient insurance coverage and benefits.
• Process claim corrections and resubmissions as needed.
• Post insurance and patient payments accurately.
• Generate and review patient statements.

Accounts Receivable & Follow-Up

• Monitor aging reports and outstanding claims.
• Investigate and resolve claim denials and rejections.
• Communicate with insurance carriers regarding claim status.
• Work with providers and staff to obtain necessary documentation for reimbursement.

Compliance & Reporting

• Maintain HIPAA compliance and patient confidentiality.
• Stay current with coding updates and payer regulations.
• Assist with audits and compliance reviews.
• Prepare billing and reimbursement reports for management.

Additional Administrative & Front Desk Responsibilities

In addition to billing and coding duties, this position will assist with front office operations to ensure an exceptional patient experience and smooth clinic workflow.

Front Desk Support

• Assist with patient check-in and check-out processes.
• Verify insurance eligibility and collect copays, deductibles, and patient balances.
• Answer incoming phone calls and direct inquiries appropriately.
• Schedule and confirm patient appointments.
• Maintain accurate patient demographic and insurance information.

Referrals & Medical Records

• Coordinate referrals to specialists and ancillary services.
• Obtain prior authorizations when required.
• Process requests for medical records in accordance with HIPAA regulations.
• Communicate with patients, providers, and referral offices regarding referral status and medical documentation.
• Assist providers and clinical staff with obtaining outside medical records when necessary.

Team Collaboration

• Cross-train to provide coverage for front desk staff as needed.
• Support clinic operations during busy periods and staff absences.
• Work closely with providers, nursing staff, and administration to ensure efficient patient care and workflow.

Qualifications

Required

• High School Diploma or GED
• Certified Professional Coder (CPC), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), or equivalent medical billing/coding certification
• Minimum 2 years of medical billing and coding experience in a physician office, outpatient clinic, family practice, urgent care, or similar healthcare setting
• Knowledge of ICD-10, CPT, and HCPCS coding
• Experience with Medicare, Medicaid, and commercial insurance billing
• Strong attention to detail and organizational skills
• Excellent communication and problem-solving abilities
• Proficiency with electronic medical records (EMR) systems

Ideal Candidate

The ideal candidate is highly organized, proactive, and capable of working independently while collaborating with providers and administrative staff. They are passionate about accuracy, understand the importance of clean claims, and take ownership of the revenue cycle process from claim submission through payment collection.

Schedule

• Monday – Friday
• Day Shift
• No Nights
• No Weekends

Pay: $16.00 - $22.00 per hour

Benefits:

• 401(k)
• Health insurance
• Paid time off

Experience:

• Medical Billing and Coding: 2 years (Required)

License/Certification:

• CPC (AAPC) or CCS (AHIMA) certification? (Preferred)

Work Location: In person

Salary : $16 - $22