Company Overview
Since 2005, Tech Observer has been a trusted provider of Staffing (Clinical, Scientific, IT, and Professional) and Clinical Research Services. Headquartered in New Jersey, USA, we also have offices in India, the UK, Denmark, and Singapore.
As an ISO 9001:2008, ISO 14155:2011, and ISO 27001 certified company, we are committed to quality and responsible work ethics. We take pride in delivering strategic, real-time insights that help our clients achieve their goals. Our flexible service offerings range from standalone solutions to comprehensive end-to-end support, tailored to meet diverse client needs.
With a global team of 500 professionals, we serve 50+ companies across 30+ countries.
Our Key Services:
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Clinical Operations
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Clinical Data Management
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Biostatistics & SAS Programming
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Medical Writing & Scientific Communications
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Post-Marketing Clinical Studies
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Staffing (U.S. only)
Job Summary
We are seeking a skilled Medical Coder and Billing Specialist to provide specialized coding services for inpatient and outpatient medical office visits. This role involves reviewing physician coding, ensuring accuracy, and providing updates as needed.
Additionally, you will be responsible for comprehensive financial counseling, including setting patient expectations, discussing financial options, establishing payment plans, handling one-time settlements, and resolving unpaid balances. You will also assist patients with understanding their insurance coverage, particularly out-of-network benefits, pre-determination of benefits, appeals, and pre-certification limitations.
Key Responsibilities
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Review and update physician coding for accuracy and compliance.
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Provide financial counseling to patients, discussing payment plans and financial options.
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Explain insurance coverage details and financial implications of out-of-network benefits.
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Develop and manage fee schedules for self-pay patients.
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Process Worker’s Compensation claims, addressing and resolving discrepancies.
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Conduct negotiations with insurance companies, establishing communication with pre-certification units.
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Verify insurance and registration data for scheduled procedures and review encounter forms.
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Obtain pre-certifications for scheduled admissions.
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Enter office, inpatient, and outpatient charges with accurate coding.
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Post payments in IDX, manage missing charges, edits, denials, and process appeals.
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Track, quantify, and report on denied claims, facilitating cash flow management.
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Assist with eligibility and reimbursement inquiries and resolve billing issues.
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Research and resolve misdirected or unidentified payments.
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Ensure compliance with government regulations while addressing credit balance reports.
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Analyze claims system reports to identify and recover underpayments from carriers.
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Address credentialing issues for department physicians.
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Maintain a strong understanding of medical terminology, ICD-10-CM/PCS, CPT, and HCPCS coding through continued education.
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Collaborate with practice management, leadership, and physicians to review Accounts Receivable and billing concerns.
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Mentor junior billing staff and support the Billing Manager/Revenue Cycle Manager in training initiatives.
Required Skills
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Strong organizational skills with the ability to multitask.
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Excellent communication and customer service abilities.
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Solid understanding of medical terminology and anatomy.
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High attention to detail and accuracy in coding and billing processes.
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Strong calculation, verbal, and analytical skills.
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Ability to conduct research and analyze billing trends effectively.
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