Medical Billing and Coding Specialist

POSITION: Medical Billing and Coding Specialist

DEPARTMENT: Billing Office

REPORTS TO: Practice Administrator

JOB SUMMARY: A busy Ophthalmology clinic is seeking to hire an experienced Medical and Billing Coding Specialist located in Albuquerque, NM. The proper candidate would be responsible for all phases of coding, billing, insurance payment posting/payment downloads, and account follow-up by using accepted billing practices and ensure thorough and consistent account resolution with insurance payers.

JOB TYPE: Full-time


  • High school diploma
  • 3 years in medical billing/coding
  • Excellent customer service skills
  • Strong written and verbal communication skills
  • Ability to manage relationships with various insurance payers
  • Must be detail oriented and ability to multi-task and stay organized
  • Responsible use of confidential information following HIPAA guidelines
  • Working knowledge of CPT/ICD-10 coding and medical terminology
  • At least 3 years of insurance billing in a medical office (to include working claim denials and outstanding AR, multiple carrier experience with EOB's and claim denials)
  • Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement
  • Must have thorough understanding of Medicare/Medicaid laws, managed care and commercial health insurances
  • Self-motivated; able to work productively, effectively and independently in a fast paced environment
  • Must have predictable and consistent attendance


  • Previous Ophthalmology coding/billing experience
  • Knowledge of EMR PM systems


  • Coding review, charge entry and billing of all patient visits
  • Review all payments and denials as received from the insurance company, file appeals as needed
  • Review and interpret clinical documentation to identify pertinent diagnosis/procedures and apply correct ICD-10 CPT codes keeping within coding guidelines
  • Post payment from EOB's and download electronic payments
  • Discuss financial arrangements with patients
  • Send out monthly statements
  • Provide excellent customer service when assisting patients in understanding their balance
  • Assist with authorizations and insurance verification when needed
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