Medical Coder and Biller Needed in Carteret, NJ
Job SummaryWe are seeking a detail-oriented and experienced Medical Coder and Biller to join our team. The ideal candidate will be responsible for accurately coding medical diagnoses, procedures, and services using current coding systems such as ICD-10, CPT, and DRG. This role involves managing medical billing processes, ensuring compliance with industry standards, and supporting the efficient operation of our medical office. The position offers an opportunity to work in a professional environment dedicated to providing quality patient care through precise documentation and billing practices.
Skills Needed
Strong attention to detail and accuracy, especially when reviewing patient information, insurance data, and billing codes.
Thorough knowledge of Commercial and No-Fault insurance, including PIP (Personal Injury Protection) and Workers’ Compensation.
Excellent organizational abilities with the capacity to manage a high-volume workload efficiently.
Exceptional communication skills, with the ability to communicate clearly and concisely both verbally and in writing.
Critical thinking and problem-solving skills, with the ability to quickly identify, troubleshoot, and resolve issues.
Ability to multitask effectively and handle several responsibilities simultaneously with professionalism.
Strong prioritization skills in a dynamic and shifting work environment.
Proficiency with Practice Management and Electronic Health Records (EHR) systems, specifically EClinicalWorks.
Solid understanding of medical billing, documentation, and coding standards, including ICD-9, ICD-10, CPT, and DRG systems.
Familiarity with patient account ledgers, financial documentation, and insurance workflows.
Responsibilities
Review, verify, and update patient demographics and insurance information to ensure complete accuracy prior to billing.
Prepare, code, and submit insurance claims using ICD-9, ICD-10, CPT, and DRG coding systems, ensuring compliance with payer-specific requirements.
Manage No-Fault and Workers’ Compensation billing, including PIP claims, ensuring adherence to state regulations.
Submit Precertification Authorizations
Conduct arbitration preparation, including documentation gathering, case file review, and coordination with legal teams.
Maintain and review patient account ledgers, identifying outstanding balances, payment discrepancies, and required follow-up actions.
Communicate and correspond with legal professionals, adjusters, and external parties regarding claims, documentation, and case status.
Follow up on unpaid, denied, or delayed claims, identify root causes, and take corrective actions to ensure timely reimbursement.
Maintain accurate, compliant medical records and billing documentation, adhering to all legal, regulatory, and organizational standards.
Collaborate with healthcare providers and clinical staff to clarify discrepancies in medical records, coding, or billed services.
Stay current with medical billing regulations, payer policy updates, state guidelines, and industry coding changes to ensure ongoing compliance.
Support internal and external audits by preparing required reports, documentation, and claims histories.
Ensure all billing activities follow HIPAA regulations, confidentiality standards, and ethical billing practices.
Qualifications
Proven experience in medical coding and billing within a healthcare setting.
Proficiency with EMR/EHR systems and familiarity with medical office workflows.
Knowledge of ICD-9, ICD-10, CPT coding systems, DRG classifications, and medical terminology.
Strong understanding of medical records management and documentation standards.
Experience with medical collection processes is a plus.
Excellent attention to detail, organizational skills, and ability to work independently.
Certification in Medical Coding (such as CPC or CCS) is preferred but not required.
Prior experience working with insurance companies and understanding of reimbursement procedures is advantageous. This role is vital for ensuring accurate financial operations within our healthcare practice while supporting optimal patient care documentation.
Job Type: Full-time
Pay: $20.00 - $24.00 per hour
Benefits:
Dental insurance
Health insurance
Paid time off
Vision insurance
Work Location: In person