Job Overview We are seeking a highly skilled Medical Billing and Coding Specialist to join our healthcare team. In this role, you will be responsible for accurately coding medical diagnoses and procedures, managing billing processes, and ensuring compliance with healthcare regulations. Your expertise will support efficient revenue cycle management, facilitate timely insurance claim processing, and maintain precise medical records. The ideal candidate will possess a comprehensive understanding of medical coding guidelines, health insurance procedures, and electronic health record (EHR) systems. This position offers an opportunity to contribute significantly to the financial health of our organization while ensuring the integrity of patient data. Duties Code and/or review diagnoses, co-morbidities, complications, and diagnostic procedures. Apply current CPT, HCPCS, and other applicable coding systems . Review medical records for accurate and compliant coding in accordance with CMS guidelines and current reimbursement policies. Stay current with coding, compliance, and reimbursement requirements. Manage electronic health record (EHR) and EMR systems for billing and coding purposes, maintaining data integrity and confidentiality. Collaborate with healthcare providers to clarify documentation and ensure accurate coding for revenue cycle management. Maintain detailed documentation of billing activities, medical records, and coding adjustments for audit readiness. Stay updated on changes in medical terminology, coding guidelines (including
ICD-10/ICD-9
), and health insurance policies to optimize billing accuracy. Assist in training staff on new coding practices or updates to billing software systems as needed. Skills Certified Professional Coder (CPC) certification preferred. Extensive knowledge of
ICD-10/ICD-9
coding systems, CPT coding, DRG classifications, and medical terminology. Proficiency in using billing software, EMR/EHR systems, and electronic health record management tools. Strong understanding of health insurance claim processing procedures and third-party billing practices. Familiarity with revenue cycle management principles and medical collection strategies. Ability to interpret medical records accurately and apply appropriate coding guidelines for inpatient and outpatient services.