Medical Billing
Emed Coders
Published Date: • California City, USA (On-Site)
Description
Emed Coders is seeking an experienced Medical Billing Specialist to join our dynamic team of 48 professionals. The ideal candidate will bring over nine years of expertise in medical billing, coding, and revenue cycle management, ensuring the accurate processing and submission of insurance claims. This role demands proficiency in ICD-10-CM, CPT, and HCPCS coding systems, as well as a strong understanding of denial management and appeals processes. The successful candidate will play a crucial role in maintaining compliance with HIPAA regulations and utilizing electronic health record (EHR) and practice management systems effectively. As a key member of Emed Coders, you will be responsible for facilitating smooth and efficient billing operations by managing claims scrubbing, rejection resolution, payment tracking, and modifier assignment. You will lead efforts to optimize the medical billing revenue cycle workflow, collaborating closely with healthcare providers and insurance companies to resolve issues promptly. Your leadership of a substantial team will emphasize accuracy, timely communication, and building lasting relationships with clients and colleagues, ultimately contributing to the organization’s financial health and service quality.
Responsibilities
- Manage the end-to-end medical billing process, including accurate submission of claims using ICD-10-CM, CPT, and HCPCS coding standards.
- Oversee the medical billing revenue cycle workflow from claim generation to payment posting and reconciliation.
- Lead denial management and appeals by investigating rejected claims, identifying issues, and resubmitting corrected claims to insurance providers.
- Ensure compliance with HIPAA regulations in all billing operations and maintain the confidentiality of patient information.
- Utilize electronic health record (EHR) and practice management systems to update patient records, process charges, and track payment status.
- Assign and validate CPT and HCPCS modifiers to optimize reimbursement and prevent claim denials.
- Perform claim scrubbing to identify and correct errors prior to claim submission, reducing rejection rates.
- Monitor accounts receivable and conduct follow-ups on outstanding payments with insurance companies and patients as necessary.
- Develop and implement process improvements to increase billing accuracy and efficiency across the team.
- Train, supervise, and support a team of 48 personnel, fostering a collaborative, knowledgeable, and motivated work environment.
- Communicate effectively with healthcare providers, insurance companies, and internal stakeholders to resolve billing discrepancies and inquiries.
- Report on billing trends, denial rates, and team performance to senior management, recommending solutions to improve revenue cycle outcomes.
Experience
9 Years
Apply By
Required Skills
- ICD-10-CM
- Insurance Claim Processing
- Revenue Cycle Management
- Payment Tracking
- accounts receivable follow-up
- Claim Scrubbing and Rejection Resolution
- Modifier Assignment and Validation
- Medical Billing Revenue Cycle Workflow
- EHR and Practice Management Software Proficiency
- HCPCS Level II Coding for Supplies and Services
- CPT Procedure Coding
- Electronic Health Record And Practice Management Systems
- HIPAA Compliance
- Denial Management and appeals
- HCPCS Coding
- CPT
- Medical Claims Processing
Nice to Have Skills
- Team Leadership
- Communication
- Problem Solving