Proven Medical Coding and Billing Specialist with extensive experience at Digestive Medicine Associates, showcasing expertise in ICD-10 and CPT coding, alongside exceptional organizational abilities. Achieved high accuracy in claim submissions, ensuring robust reimbursement rates and compliance with HIPAA. Excelled in insurance verification and medical record review, driving efficient billing processes and enhancing revenue cycle management.
• Accurately assign ICD-10, CPT, and HCPCS codes to medical procedures and diagnoses.
• Process and submit claims to Medicare, Medicaid, and private insurers, ensuring timely reimbursement.
• Review medical records for completeness and accuracy before claim submission.
• Prepare and submit claims to insurance companies for reimbursement, ensuring they are correctly coded to facilitate payment.
• Identify and resolve claim denials through appeals and resubmissions.
• Verify insurance coverage and pre-authorization requirements for procedures
• Maintain compliance with HIPAA regulations and insurance policies.
• Utilize EHR and practice management software for charge entry, payment posting, and claim tracking.