Medical Coder

We are looking for a detail-oriented Medical Coder to support revenue cycle operations for a healthcare team in Pittsburgh, Pennsylvania. This Long-term Contract position focuses on accurate claim preparation, coding review, payment posting, and follow-up with payers and patients to help maintain timely reimbursement. The ideal candidate brings hands-on medical billing and coding experience, strong knowledge of payer requirements, and the ability to work collaboratively in a fast-paced clinical environment. Monday - Friday 8am-4:30pm

Responsibilities:

• Examine claims before release to verify coding accuracy, completeness, and compliance with payer rules.

• Prepare and transmit insurance claims through electronic and manual submission channels as needed.

• Monitor aging accounts on a routine basis and take appropriate action to support collection targets for older balances.

• Investigate denied or rejected claims each day, correct issues, and pursue resolution through follow-up and appeal activity.

• Record insurance and patient payments, apply necessary adjustments, and maintain accurate account balances.

• Communicate with patients regarding billing questions and outstanding balances while following established collection practices.

• Identify credit balances or overpayments and process appropriate research and resolution steps.

• Perform coding and documentation audits, review clinical and surgical records, and provide feedback when coding does not align with supporting documentation.

• Stay current on insurer policy updates and coding guidance, reconcile logs and supporting records, and maintain organized claim documentation.

• High school diploma or equivalent required.
• At least 1 year of experience in multi-specialty medical billing, with ophthalmology or optometry exposure preferred.
• Working knowledge of ICD-10, CPT, and outpatient coding practices.
• Certification in medical billing, coding, or ophthalmology coding is preferred.
• Ability to review medical documentation and assign codes supported by the clinical record.
• Strong communication skills with the ability to work effectively with providers, staff, payers, and patients.
• Detail-oriented approach with the ability to manage records accurately and handle multiple billing tasks efficiently.