Family Medicine Coder and Biller

Position Overview:
We are seeking a skilled and detail-oriented individual to join our team as a Coder and Biller for our medical services department. The ideal candidate will have expertise in medical coding and billing procedures, with a strong understanding of reimbursement processes and regulations specific to family medicine.

Responsibilities:

Medical Coding:

• Assign accurate medical codes to diagnoses, procedures, and services performed by healthcare providers using ICD-10-CM, CPT, and HCPCS code sets.
• Review medical records and encounter forms to ensure completeness, accuracy, and compliance with coding guidelines.
• Resolve coding discrepancies or inconsistencies by consulting with healthcare providers and other relevant staff.

Claims Processing:

• Prepare and submit electronic and paper claims to insurance companies, Medicare, Medicaid, and other third-party payers in a timely manner.
• Verify patient insurance eligibility, benefits, and pre-authorization requirements prior to claim submission.
• Monitor claim status and follow up on unpaid or rejected claims, resubmitting as necessary to ensure prompt reimbursement.

Billing and Accounts Receivable:

• Generate patient statements and invoices for services rendered, accurately reflecting patient co-payments, deductibles, and outstanding balances.
• Post payments, adjustments, and denials to patient accounts, reconciling accounts receivable and ensuring accuracy of billing records.
• Investigate and resolve billing inquiries, disputes, and discrepancies from patients, insurance companies, and other parties.

Compliance and Documentation:

• Maintain up-to-date knowledge of coding and billing regulations, including HIPAA, Stark Law, and Medicare/Medicaid guidelines.
• Ensure compliance with coding and billing policies and procedures, including documentation requirements for accurate reimbursement.
• Participate in regular audits and reviews to assess coding accuracy, identify areas for improvement, and mitigate compliance risks.

Collaboration and Communication:

• Collaborate with healthcare providers, administrative staff, and insurance representatives to resolve coding, billing, and reimbursement issues.
• Communicate effectively with patients regarding billing inquiries, insurance coverage, and financial responsibilities.
• Provide training and support to clinical staff on documentation requirements and coding best practices.

Qualifications:

• High school diploma or equivalent; Associate's degree or certification in medical coding or billing preferred.
• Certified Professional Coder (CPC) certification or Certified Coding Specialist (CCS) certification preferred.
• Minimum of 5 years of experience in medical coding and billing, preferably in a family medicine or primary care setting.
• Proficiency in medical terminology, anatomy, physiology, and disease processes.
• Strong knowledge of healthcare reimbursement methodologies, including fee schedules, coding guidelines, and payer policies.
• Familiarity with electronic health records (EHR) systems and medical billing software (e.g., Epic, Cerner, Meditech).
• Excellent attention to detail, organizational skills, and ability to prioritize tasks in a fast-paced environment.
• Strong communication and interpersonal skills, with the ability to collaborate effectively with multidisciplinary teams and communicate complex coding and billing concepts to non-technical staff.

Benefits:

• Competitive salary commensurate with experience
• Health insurance
• Paid time off and holidays
• Opportunities for professional development and training

Application Instructions:
To apply, please submit a resume outlining your qualifications and experience in medical coding and billing for family medicine. In your cover letter, please highlight any relevant certifications, coding specialties, and experience with electronic health records and medical billing software.

Note: This job description is intended to provide a general overview of the responsibilities and qualifications for the position of Coder and Biller. Specific duties and requirements may vary depending on the needs of the organization and the scope of practice in family medicine.

Job Types: Full-time, Contract

Pay: $15.00 - $18.00 per hour

Benefits:

• Health insurance
• Paid time off

Schedule:

• 8 hour shift
• Monday to Friday
• Weekends as needed

Work Location: In person