Medical Biller / Coder

Role Summary: The Medical Biller / Coder will be responsible for accurately translating medical diagnoses and procedures into standardized codes for billing and record-keeping purposes. This role is crucial for ensuring timely and accurate reimbursement from insurance providers and for maintaining precise patient records, particularly for cases involving forensic or medico-legal aspects within our organization's operational scope.

Key Responsibilities:

• Reviewing and analyzing patient medical records, including physician's notes, lab results, and diagnostic reports, to identify all services and diagnoses provided.
• Assigning appropriate ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) and CPT (Current Procedural Terminology) codes to diagnoses and procedures.
• Ensuring compliance with all relevant coding guidelines, regulations, and payer policies.
• Preparing and submitting accurate medical claims to insurance companies and government payers.
• Following up on denied or rejected claims and initiating appeals when necessary.
• Maintaining patient confidentiality in accordance with HIPAA and other applicable privacy laws.
• Communicating with physicians, other healthcare providers, and insurance company representatives to clarify information and resolve billing issues.
• Staying updated on changes in medical coding, billing regulations, and healthcare policies.