Sunrise

Medical Billing and Coding

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

Medical Billing Specialist

Administrative Assistant

• Assign incoming cases, tasks, or tickets to the appropriate team member or queue based on defined workflows
• Track task status and follow up to ensure timely completion
• Flag bottlenecks or delays to the team lead
• Maintain accurate records in internal systems to support reporting accuracy
• Monitor and process incoming system, workflow, or case-related alerts
• Triage alerts by priority and route them to the correct person or team
• Take first-line action on routine alerts and escalate complex ones
• Document alert resolution clearly and consistently
• Review incoming insurance-related correspondence for accuracy and completeness
• Verify documents against the correct patient case and insurance file
• Forward verified correspondence to billing, care coordination, or clinical teams
• Identify missing or inconsistent information and follow up as needed
• Check patient profiles for completeness and accuracy
• Flag discrepancies or outdated information for correction
• Support the insurance verification team with light data checks
• Communicate with internal U.S. teams by email
• Escalate sensitive or complex patient questions to the appropriate specialist
• Maintain structured documentation across workflows
• Follow HIPAA and data protection standards when handling patient information
• Ensure secure handling of sensitive personal and medical data in a cross-border environment

Medical Billing Specialist

Administrative Coordinator