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Medical Coder and Biller (OB/GYN Practice) NJ Best

OBGYN - 4.8

Clifton, NJ Job Details Full-time $20 - $30 an hour 1 day ago Benefits Health insurance Dental insurance Paid time off Vision insurance Employee discount Qualifications National Correct Coding Initiative (NCCI) guidelines Medicare Accounts receivable management

ICD-10-CM

Medical Coding Certification Regulatory compliance in claims processing HIPAA Bachelor's degree Payment posting in medical billing systems Business Administration Medical Billing Certification Business Associate's degree Full Job Description Medical Biller and Coder (OB/GYN Practice) Job Summary The Medical Biller and Coder is responsible for accurate and timely medical coding, billing, claims processing, reimbursement, and accounts receivable activities. This position ensures that claims are submitted correctly, denials are addressed promptly, and billing practices comply with federal and state regulations, HIPAA requirements, and payer guidelines. The ideal candidate will have at least five (5) years of hands-on experience in medical billing and coding, preferably in an OBGYN practice, with strong knowledge of insurance claims, medical coding, accounts receivable, denials, appeals, reimbursement, and payer requirements. This is a full-time, in-person position. We are seeking a reliable professional who is available to work on-site. This position is not remote and does not offer a work-from-home option. Essential Duties and Responsibilities Prepare, review, and submit electronic insurance claims accurately and on time. Review CPT, ICD-10-CM, HCPCS, and modifier coding for accuracy and compliance. Review operative reports, medical records, and provider documentation to ensure services are properly supported and coded. Obtain additional documentation when needed for claims, prior authorizations, medical necessity reviews, audits, appeals, or payer requests. Monitor daily claim submissions and resolve claim rejections before or after transmission to insurance carriers. Investigate and resolve denied, rejected, and underpaid claims. Submit corrected claims and appeals with appropriate supporting documentation. Follow up on unpaid claims through practice management systems, clearinghouses, and payer portals. Manage aging accounts receivable and take appropriate action to reduce outstanding balances. Submit primary, secondary, and tertiary claims within required payer timeframes. Review payment postings and reimbursement activity to identify discrepancies and missed revenue opportunities. Stay informed about payer policies, billing requirements, coding updates, and reimbursement changes. Maintain accurate and organized billing records. Perform routine audits of coding, charge entry, claims, payment posting, and supporting documentation. Communicate with providers and clinical staff to clarify documentation and coding requirements. Ensure billing and coding activities comply with federal and state regulations, HIPAA, payer policies, and organizational procedures. Reporting and Revenue Cycle Responsibilities Prepare and review weekly and monthly revenue cycle reports. Monitor accounts receivable, denial rates, collections, and reimbursement trends. Identify billing issues and recommend solutions to improve reimbursement and reduce denials. Work with the Practice Administrator and Business Manager on revenue cycle improvements. Assist with identifying workflow changes that improve efficiency and payment performance. Participate in updating billing and coding policies and procedures. Identify opportunities to improve workflows, reduce errors and denials, and strengthen documentation. Qualifications and Education Associate degree in Business Administration, Healthcare Administration, Health Information Management, or a related field preferred. Bachelor's degree preferred. CPC, CCS, CPB, or equivalent certification preferred. Equivalent education and relevant work experience may be considered. Experience and Knowledge Minimum of five (5) years of hands-on experience in medical billing and coding, preferably in an OBGYN specialty. Experience with insurance claims processing, accounts receivable, denial management, appeals, and payment posting. Demonstrated ability to identify and resolve billing and coding issues. Strong knowledge of CPT, ICD-10-CM, HCPCS, modifiers, NCCI edits, and medical coding guidelines. Working knowledge of Medicare, Medicaid, commercial insurance requirements, payer policies, and reimbursement practices. Knowledge of HIPAA regulations and healthcare billing compliance requirements. Experience using practice management systems, clearinghouses, and payer portals. Ability and willingness to work full-time on-site. This position is not remote.

Pay:

$20.00 - $30.00 per hour

Benefits:

Dental insurance Employee discount Health insurance Paid time off Vision insurance

Work Location:

In person