Medical Billing and Coding Specialist

Overview:
We are seeking a detail-oriented and experienced Billing & Certified Medical Coder to join our Allergy & Asthma practice. This role is responsible for accurate medical coding, timely claim submission, payment posting, denial management, and ensuring compliance with payer and regulatory requirements. Experience in allergy, immunology, and asthma-related billing is strongly preferred. This is a Hybrid position which requires weekly in-office duties.

Responsibilities:

Medical Coding

• Accurately assign CPT, ICD-10-CM, and HCPCS codes for allergy and asthma services
• Code office visits, diagnostic testing, procedures, and treatments including:
• Allergy skin testing (e.g., 95004–95075)
• Immunotherapy injections (e.g., 95115, 95117)
• Allergy serum preparation (e.g., 95165)
• Pulmonary function testing (e.g., spirometry)
• Asthma and allergy-related E/M services
• Biologic medications and injections (e.g., Xolair, Dupixent, Nucala, Fasenra)
• Ensure documentation supports coded services and meets payer guidelines

Billing & Claims Management

• Prepare, submit, and monitor insurance claims (commercial, Medicare, Medicaid)
• Post payments, adjustments, and refunds accurately
• Identify, analyze, and resolve claim denials and underpayments

Compliance & Quality

• Maintain compliance with HIPAA, CMS, and payer-specific billing regulations
• Stay current on coding updates, payer policy changes, and industry best practices
• Participate in internal audits and assist with external audits as needed

Collaboration & Communication

• Work closely with providers and clinical staff to clarify documentation and coding questions
• Communicate with insurance companies regarding claim issues
• Provide billing support and explanations to patients as needed

Required Qualifications:

• Certified Professional Coder (CPC), CCS, or equivalent coding certification (required)
• Minimum 5 years of medical billing and coding experience, preferably in Allergy, Asthma, or Immunology
• Strong knowledge of CPT, ICD-10-CM, HCPCS, and E/M coding
• Experience with insurance claim submission and denial resolution
• Proficiency with electronic health records (EHR) and practice management systems

Preferred Qualifications:

• Experience billing for allergy testing, immunotherapy, and biologic medications
• Familiarity with Medicare and commercial payer guidelines for allergy services
• Knowledge of modifier usage (e.g., -25, -59) in an allergy practice setting
• ECW experience preferred but not required.

Skills & Competencies:

• High attention to detail and accuracy
• Strong organizational and time-management skills
• Ability to work independently and as part of a team
• Excellent written and verbal communication skills
• Strong problem-solving and analytical abilities

Work Environment:

• Remote position. Requires weekly in office duties.
• May include sitting for extended periods and computer-based work

Pay: $34.00 - $38.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement

Work Location: Hybrid remote in Leominster, MA 01453

Salary : $34 - $38