Dermatology Biller & Coder

Description:

The Dermatology Medical Biller & Coder is responsible for accurately coding clinical services, submitting claims, posting payments, and ensuring timely reimbursement. This role plays a critical part in optimizing revenue cycle performance while maintaining compliance with payer guidelines, including Medicare and commercial insurance plans.

Requirements:

Medical Coding Assign accurate CPT, ICD-10, and HCPCS codes for dermatology services Review provider documentation to ensure coding accuracy and completeness Apply appropriate modifiers (e.g.,

• 25,•59,•LT/RT ) Ensure compliance with NCCI edits and payer-specific policies Identify documentation gaps and communicate with providers Charge Entry Enter charges into the practice management system (e.

g., EMA) Verify services align with documentation and scheduled visit type Ensure correct provider, location, and insurance selection Claims Submission Prepare and submit clean claims to insurance payers Review and correct claim rejections or front-end edits Monitor claim status and ensure timely filing Payment Posting Post insurance payments (ERA/EOB) and patient payments Apply contractual adjustments accurately Identify underpayments and discrepancies Accounts Receivable (A/R) Follow-Up Work denied or unpaid claims Investigate denials (authorization, medical necessity, coding errors) Submit appeals and corrected claims as needed Follow up with payers to ensure reimbursement Compliance & Auditing Maintain compliance with: CMS (Medicare) guidelines Commercial payer policies Participate in internal audits to ensure coding accuracy Stay updated on coding changes and dermatology billing updates Dermatology Biller Preferred