Job Description

Job Description

Job Description

Pain & Spine Physicians Surgery Center is seeking an experienced Medical Biller & Coder to join our team. This position will work closely with and assist the Revenue Cycle Management Manager in managing daily billing operations, maintaining accurate claims, and supporting efficient revenue cycle processes.

The ideal candidate will have a strong background in medical billing and coding, with specific experience in ambulatory surgery center facility billing and anesthesia billing . This individual will assist with claim submission, payment posting, denial management, insurance follow-up, accounts receivable monitoring, and other revenue cycle functions to support timely and accurate reimbursement.

Key Responsibilities

• Assist the RCM Manager with daily billing operations and revenue cycle activities.
• Prepare, review, and submit facility claims using the UB-04 claim form.
• Prepare, review, and submit anesthesia and professional claims using the appropriate CMS-1500/HCFA claim form.
• Review medical records and supporting documentation to ensure accurate coding and billing.
• Apply appropriate CPT, ICD-10-CM, HCPCS, and anesthesia billing codes, as applicable to assigned responsibilities.
• Review and resolve claim rejections, denials, and underpayments.
• Follow up with insurance companies regarding outstanding claims and accounts receivable.
• Identify billing discrepancies and submit corrected claims or appeals as needed.
• Monitor aging reports, outstanding balances, and reimbursement trends.
• Assist with account reconciliation and the preparation of billing and revenue cycle reports.
• Maintain accurate billing records and documentation.
• Communicate with clinical and administrative staff to resolve billing and documentation issues.
• Support the RCM Manager with identifying workflow inefficiencies and implementing process improvements.
• Ensure compliance with applicable payer requirements, HIPAA regulations, and billing and coding guidelines.
• Perform additional billing and revenue cycle duties as assigned by the RCM Manager.

Qualifications

• Previous experience in medical billing and coding required.
• Experience with both ASC facility billing and anesthesia billing strongly preferred.
• Knowledge of UB-04 and CMS-1500/HCFA claim submission requirements.
• Working knowledge of CPT, ICD-10-CM, HCPCS, and anesthesia billing methodologies.
• Experience with insurance follow-up, denial resolution, payment posting, and accounts receivable management.
• Familiarity with commercial insurance, Medicare, and payer-specific billing guidelines.
• Proficiency with electronic billing systems and practice management software.
• Strong organizational skills and attention to detail.
• Ability to prioritize tasks, meet deadlines, and manage multiple responsibilities.
• Ability to work independently while collaborating effectively with the RCM Manager and other team members.
• Coding certification (CPC, CCS, or equivalent) preferred.

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