What are the responsibilities and job description for the Medical Billing and Coding Specialist position at Lyons Pediatrics Care?
Overview
Join our dynamic healthcare team as a Medical Billing and Coding Specialist, where your expertise will directly impact the efficiency and accuracy of medical reimbursement processes. In this vital role, you will be responsible for translating healthcare services into universally recognized codes, ensuring precise billing, and maintaining comprehensive medical records. Your energetic approach and attention to detail will help streamline operations, support patient care, and uphold compliance standards across the organization.
Responsibilities
- Review and analyze medical documentation to assign appropriate ICD-10 (International Classification of Diseases, Tenth Revision), CPT (Current Procedural Terminology), and DRG (Diagnosis-Related Group) codes for billing purposes.
- Ensure accurate coding by staying current with updates to ICD-9 (prior version), ICD-10, CPT coding systems, and related medical terminology.
- Prepare and submit clean claims using Electronic Medical Record (EMR) or Electronic Health Record (EHR) systems, adhering to insurance guidelines and regulations.
- Follow up on unpaid or rejected claims through effective medical collection strategies while maintaining professional communication with insurance companies and patients.
- Maintain detailed and organized medical records, including documentation of diagnoses, procedures, and billing information for audit readiness.
- Collaborate with healthcare providers to clarify documentation discrepancies and ensure compliance with coding standards.
- Stay informed about industry changes in medical coding regulations to ensure ongoing compliance and optimize reimbursement processes.
- Responsibilities
- Protect patients by observing HIPAA Law.
QualificationsRequired
- Billing and Coding Certification.
- Experience in a clinical setting.
- Strong communication and organizational skills.
- Must have a positive attitude and take initiative.
- Maintain thorough knowledge of clinic policy and procedures.
- Maintain thorough knowledge of EHR billing and collection procedures.
- Clear all patient billing holds in system for all clinics.
- Keep clinicians up to date on current coding requirements.
- Clear all payment problems in EHR.
- Contact/respond to patient billing questions.
- Contact insurers when necessary.
- Make collection calls when necessary.
- Prepare monthly spreadsheet of deposits made by EHR system for the Financial Services Department.
- Process insurance checks received through EHR.
- Substitute for front desk personnel.
- Other duties as assigned.
Experience
- Proven experience in medical billing and coding within a healthcare setting, demonstrating a strong understanding of medical terminology and records management.
- Familiarity with EMR/EHR systems used for billing, coding, and record keeping.
- Knowledge of ICD-9, ICD-10, CPT coding systems, as well as DRG classifications for hospital billing scenarios.
- Experience handling medical collections processes with professionalism and persistence.
- Ability to interpret complex medical documentation accurately and translate it into precise codes.
- Prior work in a medical office environment is preferred, showcasing organizational skills and attention to detail.
- Certification in Medical Coding (such as CPC or CCS) is highly desirable to validate expertise. Embark on a rewarding career where your coding precision fuels efficient healthcare delivery! We’re committed to supporting your growth through ongoing training opportunities while fostering a lively team environment dedicated to excellence in patient care administration.
Pay: $21.00 - $25.00 per hour
Expected hours: 35.0 per week
Benefits:
- 401(k)
- Paid time off
Work Location: In person
Salary : $21 - $25