Dreem Health | Sunrise

Medical Billing and Coding

• Review clinical documentation and assign accurate diagnosis and procedure codes in accordance with payer guidelines and coding regulations (ICD-10, CPT, HCPCS).
• Process and submit insurance claims, ensuring coding accuracy and compliance with payer-specific requirements.
• Verify claim accuracy prior to submission and resolve billing discrepancies proactively.
• Investigate and follow up on unpaid balances, underpayments, and outstanding claims.
• Work directly with insurance carriers to resolve reimbursement issues and recover collectible dollars.
• Track, submit, and follow up on appeals and reconsiderations through resolution.
• Accurately post insurance and patient payments to accounts.
• Maintain clear, concise, and timely notations of all account activity.
• Maintain accurate patient billing records and documentation in the practice management system.
• Stay current on coding updates, payer policy changes, and industry regulations.
• Collaborate with providers and administrative staff to support efficient, compliant billing operations.
• Assist with internal audits and implement best practices to improve billing accuracy and clean claim rates.
• Adhere to established procedures, protocols, and HIPAA requirements; escalate complex issues to supervisor as appropriate.
• Complete additional tasks as assigned.

Medical Billing Specialist