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Medical Billing and Coding Specialist
Allegheny Reproductive Health Center
Pittsburgh, USA
Full-time
Junior · 2–3 years experience
Onsite
Discovered 1 weeks ago
Communication
Key Skills for This Role
Communication
Full Job Posting
Key Responsibilities
- Medical Coding: Review, analyze, and translate clinical documentation, physician notes, and laboratory reports into accurate alphanumeric codes using ICD-10-CM, CPT, and HCPCS Level II code sets.
- Claims Submission: Prepare, validate, and electronically transmit clean insurance claims to commercial insurance carriers, Medicare, and Medicaid.
- Insurance Verification: Verify patient insurance eligibility, benefits coverage, and coordinate necessary pre-authorizations or referrals prior to patient visits.
- Denials & Appeals Management: Monitor claim status, identify root causes for rejections or denials, correct errors, and submit formal appeals to insurance companies.
- Accounts Receivable (AR) Tracking: Maintain and follow up on outstanding patient and insurance aging balances to reduce days in AR.
- Patient Accounts & Support: Answer patient inquiries regarding statement balances, explain insurance Explanation of Benefits (EOBs), and establish authorized payment plans.
- Regulatory Compliance: Maintain absolute confidentiality and strictly adhere to HIPAA guidelines, OIG regulations, and internal compliance protocols.
- Any other duties as assigned by the supervisor.
- Skills/Qualifications:
- Education: High School Diploma or equivalent required; an Associate Degree in Health Information Technology or a related field is highly preferred.
- Experience: Minimum of 2-3 years of direct experience in medical billing and coding within a clinic, hospital, or billing agency with preferred expertise in women’s health (OBGYN, family planning)
- Technical Skills: Proficiency with electronic health records (EHR/EMR) software (e.g.,AthenaHealth) and clearinghouse platforms.
- Medical Knowledge: Understanding of medical terminology, anatomy, physiology, and diverse insurance payer guidelines.
- Soft Skills: Excellent analytical thinking, strong mathematical accuracy, clear communication skills, and high attention to detail. Ability to work with minimal supervision and direction. Ability to work and interact with a diverse team and patient population.
Qualifications
- Proficiency with electronic health records (EHR/EMR) software (e.g.,AthenaHealth) and clearinghouse platforms.
- Medical Knowledge: Understanding of medical terminology, anatomy, physiology, and diverse insurance payer guidelines.
- Soft Skills: Excellent analytical thinking, strong mathematical accuracy, clear communication skills, and high attention to detail. Ability to work with minimal supervision and direction. Ability to work and interact with a diverse team and patient population.
Preferred Qualifications
- Minimum of 2-3 years of direct experience in medical billing and coding within a clinic, hospital, or billing agency with preferred expertise in women’s health (OBGYN, family planning)
About Allegheny Reproductive Health Center
Hospitals & Health Systems18 employeesFounded 1975
Private Pittsburgh reproductive health clinic providing abortion, gynecological, and LGBTQIA+-inclusive care.
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