Medical Coder and Biller - Authorization & Verification Specialist

Key Responsibilities:

  • Code Assigning and Documentation:
  • Assign accurate medical codes (ICD-10, CPT, some of HCPCS) for procedures, diagnoses, and treatments based on patient medical records.
  • Ensure the proper coding of both routine and specialized procedures.
  • Verify that all coding aligns with the medical documentation, ensuring that it reflects the correct diagnosis, procedures, and any other relevant information.
  • Medical Record Review:
  • Review patient charts and medical records to extract relevant information for accurate coding.
  • Ensure all necessary information is included, such as patient history, exam findings, diagnosis, and treatment plan.
  • Insurance and Billing Compliance:
  • Ensure coding practices comply with federal, state, and payer-specific regulations (e.g., Medicare, Medicaid, private insurers).
  • Audit and Quality Control:
  • Conduct regular audits of coded documents to ensure accuracy and adherence to industry standards and guidelines.
  • Identify and correct any discrepancies in coding, improving the overall accuracy of documentation.
  • Stay updated on coding changes, updates to ophthalmology procedures, and compliance regulations.

Required Skills & Qualifications:

  • Educational Requirements:
  • High school diploma or equivalent (required).
  • Post-secondary education or certification in medical coding, health information management, or a related field (preferred).
  • Knowledge & Expertise:
  • Strong knowledge of coding systems: ICD-10, CPT, and some of HCPCS, and understanding of modifiers.
  • Specific knowledge in ophthalmology procedures, treatments, and terminology.
  • Familiarity with medical billing software and electronic health record (EHR) systems.
  • In-depth understanding of medical documentation and compliance standards.
  • Experience:
  • 1-3 years of experience as a medical coder, ideally in medical facility.
  • Experience with medical billing and working directly with insurance providers.
  • Soft Skills:
  • Attention to detail and a high level of accuracy in coding.
  • Ability to work independently and as part of a team.
  • Strong organizational skills and time management.
  • Excellent written and verbal communication skills.
  • Ability to handle confidential patient information responsibly.

Work timings - US shift hours

Job Type: Full-time

Work Location: Remote

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