Job Title: Medical Billing/Coding Specialist

Department: Billing

Immediate Supervisor Title: Billing Manager

Job Supervisory Responsibilities: None

General Summary: A nonexempt position responsible for processing and managing all billable services.

Essential Job Responsibilities:

  1. Coding and data entry of all billable charges per established procedures.
    1. IH/OH/Office
  2. Production of electronic and paper claims to insurance plans.
  3. Processing of patient statements according to practice protocols.
  4. Data entry and verification of insurance.
  5. Accurately apply patient and insurance payments.
  6. Insurance accounts receivable follow up. This would include investigating denied, underpaid and overpaid claims and doing appeals.
  7. Reconcile customer disputes as they pertain to payment of outstanding balances that are due. Provide excellent & considerate customer service to patients.
  8. Take accountability for personal productivity and quality output.
  9. Any other tasks required to continue or maintain the billing process.

Education: High school diploma or equivalent, some college preferred.

Certified Coder a plus

Experience: Minimum of two years billing experience in a health care organization. Previous experience in medical billing, coding and collection activities.

Gastroenterology billing experience a plus.

Other Requirements: None

Performance Requirements:


  1. Knowledge of billing policies and procedures for multi-physician specialty practice.
  2. Knowledge of practice operating policies.
  3. Knowledge of insurances and third party billing
  4. Knowledge of ICD 10 and CPT-4 coding.



  1. Proficient skills in computer programs including medical management software, Allscripts a plus.
  2. Skill in computer and spreadsheet applications.
  3. Skill in effective oral and written communication.
  4. Ability to read, understand and explain insurance EOBs
  5. Skill in using a calculator.
  6.   Navinet, Availity, UHC Link, CHP Experience


  1. Ability to understand and interpret policies and regulations.
  2. Ability to read and interpret medical charts.
  3. Ability to examine documents for accuracy and completeness.
  4. Ability to communicate effectively and work with others.
  5. Strong interpersonal and communication skills with an ability to work effectively with patients, physicians, managers and other staff.
  6. Ability to prioritize and manage multiple responsibilities


Equipment Operated: Standard office equipment including computers, fax machines, copiers, printers, telephones, calculators, etc.

Work Environment: Position is in a well-lighted office environment.

Mental/Physical Requirements: Requires sitting and standing associated with a normal office environment. Manual dexterity using calculator.