What are the responsibilities and job description for the Medical Billing and Coding Specialist position at Gulf Coast ABC Pediatrics?
Job Overview
We are seeking a detail-oriented and experienced Medical Billing and Coding Specialist to join our healthcare team. The ideal candidate will be responsible for accurately coding medical procedures and diagnoses, managing billing processes, and ensuring compliance with healthcare regulations. This role requires a strong understanding of medical terminology, coding systems, and electronic health record (EHR) systems to facilitate efficient billing operations and support optimal revenue cycle management.
Duties
- Review and analyze superbills to assign appropriate ICD-9, ICD-10, CPT, and DRG codes.
- Ensure accurate documentation of diagnoses and procedures using standardized medical coding systems.
- Prepare and submit insurance claims using EMR/EHR systems, ensuring compliance with payer requirements.
- Follow up on unpaid or rejected claims through medical collection processes.
- Maintain detailed and organized medical records in accordance with privacy regulations.
- Collaborate with healthcare providers to clarify documentation and improve coding accuracy.
- Stay updated on changes in coding guidelines, insurance policies, and healthcare regulations.
- Assist in audits and reviews to ensure billing accuracy and regulatory compliance.
- Maintaining facility and provider credentialing and fees schedules.
- Communicating with patients and staff concerning insurance and billing issues.
- Maintaining a good work ethic.
Experience
- Proven experience in medical billing and coding within a healthcare setting.
- Strong knowledge of ICD-9, ICD-10, CPT coding, and DRG classifications.
- Familiarity with medical terminology, medical records management, and electronic health record (EHR) systems.
- Experience working with medical office workflows, insurance claims processing, and collections.
- Prior use of EMR/EHR platforms is preferred.
- Knowledge of medical billing software and familiarity with healthcare compliance standards is a plus.
- Excellent attention to detail, organizational skills, and the ability to interpret complex medical documentation are essential for success in this role.
Work Location: In person