Senior Medical Coder
3 weeks ago
The Sr. Medical Biller/Coder reviews clinical documentation, assigns medical codes (CPT, ICD-10, HCPCS), and ensures compliance with coding guidelines and regulations. They handle claim rejections, unpaid claims, and work closely with the RCM team to maximize revenue and minimize claim denials.
• Review and analyze clinical documentation from physicians and vision care providers.
• Assign appropriate CPT, ICD-10, and HCPCS codes based on the services provided.
• Prepare and submit claims to insurance companies, Medicare, and other third-party payers.
• Monitor the status of submitted claims and resolve issues related to claim rejections, denials, or underpayments.
• Track and manage accounts receivable to maintain an accurate record of outstanding payments.
• Generate reports on coding accuracy, claim denial rates, and revenue impacts related to coding practices.
• Analyze coding data to identify trends, areas for improvement, and opportunities for revenue optimization.
Required Skills and Qualifications:
• At least 4 years of Medical Billing and/or Coding experience.
• Strong knowledge and understanding of ICD-10, CPT, modifier codes.
• Excellent verbal, written, and interpersonal communication skills.
• Proficiency in electronic health records (EHR) systems and practice management software.
• Strong analytical skills and attention to detail.
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