We are looking for a detail-oriented Medical Coder to support revenue cycle operations for a healthcare team in Pittsburgh, Pennsylvania. This Long-term Contract position focuses on accurate claim preparation, coding review, payment posting, and follow-up with payers and patients to help maintain timely reimbursement. The ideal candidate brings hands-on medical billing and coding experience, strong knowledge of payer requirements, and the ability to work collaboratively in a fast-paced clinical environment. Monday - Friday 8am-4:30pm
Responsibilities:
โข Examine claims before release to verify coding accuracy, completeness, and compliance with payer rules.
โข Prepare and transmit insurance claims through electronic and manual submission channels as needed.
โข Monitor aging accounts on a routine basis and take appropriate action to support collection targets for older balances.
โข Investigate denied or rejected claims each day, correct issues, and pursue resolution through follow-up and appeal activity.
โข Record insurance and patient payments, apply necessary adjustments, and maintain accurate account balances.
โข Communicate with patients regarding billing questions and outstanding balances while following established collection practices.
โข Identify credit balances or overpayments and process appropriate research and resolution steps.
โข Perform coding and documentation audits, review clinical and surgical records, and provide feedback when coding does not align with supporting documentation.
โข Stay current on insurer policy updates and coding guidance, reconcile logs and supporting records, and maintain organized claim documentation.
โข High school diploma or equivalent required.
โข At least 1 year of experience in multi-specialty medical billing, with ophthalmology or optometry exposure preferred.
โข Working knowledge of ICD-10, CPT, and outpatient coding practices.
โข Certification in medical billing, coding, or ophthalmology coding is preferred.
โข Ability to review medical documentation and assign codes supported by the clinical record.
โข Strong communication skills with the ability to work effectively with providers, staff, payers, and patients.
โข Detail-oriented approach with the ability to manage records accurately and handle multiple billing tasks efficiently.