Medical Billing Specialist

Billing and Coding SpecialistDrive Revenue. Prevent Denials. Eliminate Rework.Position ImpactThe Billing and Coding Specialist accelerates revenue capture by ensuring clean claims submission, preventing denials before they occur, and proactively identifying coding issues that cause delays. Your success is measured by first-pass claim acceptance rates, reduced denial rates, and faster cash flow achieved through accurate, timely charge entry. This role directly impacts revenue performance by eliminating rework, preventing payment delays, and catching problems before they become costly denials.Core ResponsibilitiesMaximize Revenue Through Clean Claims SubmissionEnsure charges result in clean claims that pay on first submission without denials or rejectionsPrevent revenue loss by catching coding errors before claims are submittedAccelerate cash flow through timely charge entry, enabling faster billing cyclesApply correct CPT, ICD-10, and HCPCS codes that maximize appropriate reimbursementReduce claim rework and resubmissions that delay payment receiptMaintain high accuracy rates that minimize denials impacting collectionsProactively Identify and Eliminate Recurring IssuesRecognize provider documentation patterns causing repeated coding problemsEscalate systematic issues to prevent ongoing denials and revenue delaysAlert management to trends before they impact multiple claimsPartner with providers to improve documentation supporting clean claimsIdentify and communicate training needs that will reduce future errorsTake initiative to solve problems rather than repeatedly coding around themDrive Quality That Prevents Downstream Revenue ProblemsCatch laterality mismatches, documentation gaps, and coding errors before submissionEnsure diagnosis codes support medical necessity, preventing claim denialsReview clinical notes thoroughly to identify issues AR teams would face laterMaintain accuracy standards that eliminate costly denial and appeal workPerform quality self-checks preventing errors that create collection obstaclesFocus on getting claims right the first time to avoid revenue cycle delaysAccelerate Charge Processing and Reduce Lag TimeEnter charges promptly, enabling timely claim submission and faster paymentMinimize charge lag that delays billing cycles and extends days to paymentProcess high volume efficiently while maintaining quality standardsPrioritize work that has the greatest impact on revenue timingMeet productivity targets supporting departmental cash flow goalsEliminate backlogs that prevent timely revenue captureResolve Documentation Issues That Block RevenueIdentify missing information preventing accurate charge entryFollow up with providers and clinical staff to obtain documentation needed for codingClear obstacles quickly so charges can be processed without delaysEnsure supporting documentation meets payer requirements for reimbursementPrevent claims from aging in unbilled status due to incomplete informationDrive the resolution of documentation gaps that would cause denialsPerformance ExpectationsAchieve high first-pass claim acceptance rates through coding accuracyMaintain error rates that minimize denials and collection delaysProcess charges within timeframes supporting optimal cash flowProactively escalate recurring issues preventing future revenue lossMeet daily productivity targets, enabling timely billing cyclesReduce charge lag, minimizing days to claim submissionContribute to departmental goals for clean claim rates and denial reductionDemonstrate outcome focus by preventing problems rather than just processing tasksQualificationsRequired2+ years of medical billing and coding experienceStrong understanding of CPT, ICD-10, and HCPCS coding systemsProven ability to maintain high accuracy while processing high volumeKnowledge of medical terminology and clinical documentationAttention to detail with a focus on preventing errors before submissionProactive problem-solver who escalates issues and drives solutionsAbility to work independently in a remote environmentProficiency with MS Office, Excel, and practice management systemsPreferredCPC certification or working toward certificationKnowledge of personal injury billing and documentation requirementsFamiliarity with NextGen or similar healthcare systemsTrack record of high accuracy and low denial ratesExperience identifying and resolving systematic coding issuesThe Ideal CandidateViews coding as revenue enablement, not just data entryTakes ownership of claim outcomes, not just task completionProactively identifies problems and escalates before they impact multiple claimsRecognizes patterns and addresses root causes rather than repeating workaroundsDemonstrates urgency around charge timing and its impact on cash flowShows initiative in resolving documentation issues that block revenueMaintains quality focus, understanding that accuracy prevents costly reworkThinks strategically about preventing denials rather than just processing chargesCompensation & BenefitsCompetitive hourly rate with performance-based bonus potentialRemote work flexibilityComprehensive benefits: medical, dental, vision, 401(k)Professional development support, including certification and continuing educationClear advancement pathway to Senior Specialist, Auditor, or Team Lead rolesAbout AICA OrthopedicsAICA Orthopedics is Atlanta's premier integrated healthcare provider with 24 locations, specializing in orthopedic, neuro-spine, and pain management services. For 25 years, we've delivered exceptional multidisciplinary care through our team of 400+ professionals.Work Environment40 hours per week with occasional extended hours to meet deadlinesFast-paced environment focused on quality and productivityRegular communication with the team via phone, email, and video conferencingSelf-directed work requiring strong time management and accountability