Medical Billing/Coding Specialist (PT)

Related Experience:

Required Education, Knowledge, and Skills:

  • High school graduate with minimum 1 year of medical billing and coding experience.
  • Previous hospital or medical office experience is desired w/Athena training preferred, experience in Medial Billing preferred.
  • Bookkeeping, basic accounting knowledge, coding and advanced clerical skills preferred.
  • Strong interpersonal skills and a positive attitude are necessary to succeed in a team environment.
  • Good organizational skills.
  • Must be able to multi-task, exercise good judgment, be dependable, and capable of independently conducting assigned tasks and day-to-day duties efficiently, effectively, and tactfully.
  • Must have courteous, confident, and respectful telephone skills (listen well, speak clearly, and respond politely)
  • Physical capabilities in accordance with Position Description


PRIMARY DUTIES AND RESPONSIBILITIES for this position include, but are not limited to, the following…

  • Ensure that all claim assignments are worked accurately and that billing solutions are appropriate, effectively resulting in claim payments.
  • Supplies correct ICD-9-CM /ICD-10-CM diagnosis codes on all diagnoses provided.
  • Supplies correct HCPCS code on all procedures and services performed.
  • Supplies correct CPT code on all procedures and services performed.
  • Analyzes provider documentation to assure the appropriate levels are assigned using the correct CPT code.
  • Ensures that compliant, accurate and complete information appears on UB04, HCFA1500, and that it matches the encounter in the EMR.
  • Must maintain productivity levels designated by manager.
  • Must actively participate in process improvement, staff enrichment and be a positive member of the Revenue Cycle team.
  • Responsible for keeping up to date with changes in Medicare, Medicaid, and commercial policy changes.
  • Ensure compliance with standard procedures and policies in performing job operations.
  • Manage denials to reach resolution and/or exceed goals set forth by office manager.
  • Must maintain positive, respectful, and professional relationships with patients, co-workers, ancillary department, and clinic personnel at all times.

Cross train with Billing Clerks and Coders as back-up for all payer positions