The specialist will perform precise coding for telemedicine visits and manage the full insurance claims process, including submission and denial resolution. They are also responsible for ensuring HIPAA compliance and providing expert guidance on billing practices to the team.
About Us:
Dr House is a trusted leader in telemedicine, providing high-quality virtual healthcare services across the United States. Our mission is to make healthcare more accessible and convenient for patients nationwide. We are seeking a highly experienced Medical Coding and Billing Specialist to join our team and ensure the accuracy, compliance, and efficiency of our medical coding and billing processes!
Key Responsibilities:
- Perform precise coding of telemedicine visits using CPT, ICD-10-CM, and HCPCS Level II codes in compliance with US healthcare standards.
- Ensure accurate documentation review and coding to meet payer and regulatory requirements.
- Manage insurance claims processing, including submission, tracking, and resolution of denials or rejections.
- Maintain accurate patient billing records and verify insurance eligibility and benefits.
- Ensure compliance with HIPAA and other relevant healthcare regulations.
- Provide expert guidance to the team on coding updates, payer-specific guidelines, and telemedicine-specific billing practices.
- Identify areas for process improvement and contribute to the efficiency of the revenue cycle.
- Stay current on changes in coding standards, telemedicine billing practices, and payer requirements.
Qualifications:
- Certification: Valid CPC, CCS, or equivalent certification in medical coding and billing.
- Experience: Minimum of 5+ years of professional experience in medical coding and billing for the US healthcare market, with a strong focus on telemedicine.
- Advanced understanding of Telehealth coding, modifiers, and insurance payer-specific requirements.
- Experience in claim denial management and resolution, with a proven track record of success.
- Proficiency in working with EHR systems and billing software.
- In-depth knowledge of US healthcare regulations, including HIPAA compliance.
- Strong organizational, analytical, and problem-solving skills.
- Excellent communication skills, both written and verbal.
Preferred Qualifications:
- Experience working with a variety of US insurance providers, including Medicare, Medicaid, and private payers.
- Comprehensive understanding of revenue cycle management processes.
- Demonstrated ability to work independently and handle complex billing cases.
What We Offer:
- Competitive compensation package.
- Opportunity to work in a dynamic and fast-growing telemedicine company.
- Continuous professional development and training.
- Flexible remote work environment.
- A chance to make a meaningful impact on improving healthcare accessibility.