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AICA Orthopedics, P.C.

Billing & Coding Specialist

AICA Orthopedics, P.C., Marietta, Georgia, United States, 30064

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Billing and Coding Specialist Drive Revenue. Prevent Denials. Eliminate Rework.

Position Impact The Billing and Coding Specialist accelerates revenue capture by ensuring clean claims submission, preventing denials before they occur, and proactively identifying coding issues that cause delays. Your success is measured by first-pass claim acceptance rates, reduced denial rates, and faster cash flow achieved through accurate, timely charge entry. This role directly impacts revenue performance by eliminating rework, preventing payment delays, and catching problems before they become costly denials.

Core Responsibilities Maximize Revenue Through Clean Claims Submission

Ensure charges result in clean claims that pay on first submission without denials or rejections

Prevent revenue loss by catching coding errors before claims are submitted

Accelerate cash flow through timely charge entry, enabling faster billing cycles

Apply correct CPT, ICD-10, and HCPCS codes that maximize appropriate reimbursement

Reduce claim rework and resubmissions that delay payment receipt

Maintain high accuracy rates that minimize denials impacting collections

Proactively Identify and Eliminate Recurring Issues

Recognize provider documentation patterns causing repeated coding problems

Escalate systematic issues to prevent ongoing denials and revenue delays

Alert management to trends before they impact multiple claims

Partner with providers to improve documentation supporting clean claims

Identify and communicate training needs that will reduce future errors

Take initiative to solve problems rather than repeatedly coding around them

Drive Quality That Prevents Downstream Revenue Problems

Catch laterality mismatches, documentation gaps, and coding errors before submission

Ensure diagnosis codes support medical necessity, preventing claim denials

Review clinical notes thoroughly to identify issues AR teams would face later

Maintain accuracy standards that eliminate costly denial and appeal work

Perform quality self-checks preventing errors that create collection obstacles

Focus on getting claims right the first time to avoid revenue cycle delays

Accelerate Charge Processing and Reduce Lag Time

Enter charges promptly, enabling timely claim submission and faster payment

Minimize charge lag that delays billing cycles and extends days to payment

Process high volume efficiently while maintaining quality standards

Prioritize work that has the greatest impact on revenue timing

Meet productivity targets supporting departmental cash flow goals

Eliminate backlogs that prevent timely revenue capture

Resolve Documentation Issues That Block Revenue

Identify missing information preventing accurate charge entry

Follow up with providers and clinical staff to obtain documentation needed for coding

Clear obstacles quickly so charges can be processed without delays

Ensure supporting documentation meets payer requirements for reimbursement

Prevent claims from aging in unbilled status due to incomplete information

Drive the resolution of documentation gaps that would cause denials

Performance Expectations

Achieve high first-pass claim acceptance rates through coding accuracy

Maintain error rates that minimize denials and collection delays

Process charges within timeframes supporting optimal cash flow

Proactively escalated recurring issues preventing future revenue loss

Meet daily productivity targets, enabling timely billing cycles

Reduce charge lag, minimizing days to claim submission

Contribute to departmental goals for clean claim rates and denial reduction

Demonstrate outcome focus by preventing problems rather than just processing tasks

Qualifications Required

2+ years of medical billing and coding experience

Strong understanding of CPT, ICD-10, and HCPCS coding systems

Proven ability to maintain high accuracy while processing high volume

Knowledge of medical terminology and clinical documentation

Attention to detail with a focus on preventing errors before submission

Proactive problem-solver who escalates issues and drives solutions

Marietta, GA office

Proficiency with MS Office, Excel, and practice management systems

Preferred

CPC certification or working toward certification

Knowledge of personal injury billing and documentation requirements

Familiarity with NextGen or similar healthcare systems

Track record of high accuracy and low denial rates

Experience identifying and resolving systematic coding issues

The Ideal Candidate

Views coding as revenue enablement, not just data entry

Takes ownership of claim outcomes, not just task completion

Proactively identifies problems and escalates before they impact multiple claims

Recognizes patterns and addresses root causes rather than repeating workarounds

Demonstrates urgency around charge timing and its impact on cash flow

Shows initiative in resolving documentation issues that block revenue

Maintains quality focus, understanding that accuracy prevents costly rework

Thinks strategically about preventing denials rather than just processing charges

Compensation & Benefits

Competitive hourly rate with performance-based bonus potential

Comprehensive benefits: medical, dental, vision, 401(k)

Professional development support, including certification and continuing education

Clear advancement pathway to Senior Specialist, Auditor, or Team Lead roles

About AICA Orthopedics AICA Orthopedics is Atlanta's premier integrated healthcare provider with 24 locations, specializing in orthopedic, neuro-spine, and pain management services. For 25 years, we've delivered exceptional multidisciplinary care through our team of 400+ professionals.

Work Environment

40 hours per week with occasional extended hours to meet deadlines

Fast-paced environment focused on quality and productivity

Regular communication with the team via phone, email, in-person, and video conferencing

Self-directed work requiring strong time management and accountability

Requirements Required

2+ years of medical billing and coding experience

Strong understanding of CPT, ICD-10, and HCPCS coding systems

Proven ability to maintain high accuracy while processing high volume

Knowledge of medical terminology and clinical documentation

Attention to detail with a focus on preventing errors before submission

Proactive problem-solver who escalates issues and drives solutions

Marietta, GA office

Proficiency with MS Office, Excel, and practice management systems

Preferred

CPC certification or working toward certification

Knowledge of personal injury billing and documentation requirements

Familiarity with NextGen or similar healthcare systems

Track record of high accuracy and low denial rates

Experience identifying and resolving systematic coding issues

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