Medical Coding Specialist

4 weeks ago


Dallas, Texas, United States CalpionPlutus Health Full time
Job Overview

We are seeking a highly skilled Medical Coding Specialist to join our team at Plutus Health Inc. As a key member of our Revenue Cycle Management (RCM) team, you will be responsible for ensuring accurate coding of diagnoses and procedures, managing AR processes, and helping maximize reimbursement for hospital services.

Key Responsibilities

  • Medical Coding: Review medical records and assign appropriate ICD-10, CPT, and HCPCS codes for hospital-based services.
  • Charge Capture: Ensure that all services rendered are properly coded and captured for billing.
  • Denial Management: Work on resolving coding-related denials by correcting and resubmitting claims.
  • Compliance: Stay updated on payer guidelines, coding standards, and healthcare regulations to ensure compliance (e.g., HIPAA, CMS).
  • Accounts Receivable: Assist in AR management by working closely with the billing team to resolve unpaid claims.
  • Audits: Conduct coding audits to ensure accuracy and compliance in claims submission.
  • Reporting: Generate reports on coding accuracy, AR performance, and outstanding claims.

Qualifications

  • Experience: Minimum of 3-5 years of experience in hospital medical coding and AR management.
  • Certifications: CPC, CCS, or equivalent coding certification is required.
  • Knowledge: Strong understanding of hospital billing, ICD-10, CPT, and HCPCS codes, as well as Medicare, Medicaid, and private payer requirements.
  • Skills: Proficiency in coding software and medical billing platforms (e.g., Epic, Cerner), strong analytical skills, and attention to detail.

Preferred Qualifications

  • Experience in coding for large hospitals or multi-specialty healthcare facilities.
  • Strong understanding of coding guidelines for inpatient and outpatient hospital services.
  • Familiarity with denial management and AR collections processes.


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