Billing and Coding Specialist - Sleep Medicine - Ohio Sleep Medicine Institute

As a Billing and Coding Specialist, you play a vital role in our mission to improve lives. This position reviews clinical documentation to assign accurate ICD-10-CM diagnosis and CPT/HCPCS procedure codes for sleep medicine services (including polysomnography, home sleep apnea testing, MSLT, and MWT), and performs front-end and back-end billing functions including insurance verification, prior authorization, claims submission, and denial/collections follow-up.

The role requires working knowledge of both coding compliance standards and revenue cycle practices to ensure accurate, timely, and compliant reimbursement for sleep medicine services. At Vituity we know the impact you can have.

At Vituity we’ve cultivated an environment where passion thrives, and success comes through shared purpose. We were founded in a culture that values team accomplishments more than individual achievements, an approach we call “culture of brilliance.” Together, we leverage our strengths and experiences to make a positive impact in our local communities. We foster this through shared goals and helping our colleagues succeed, and we also understand the importance of recognition, taking the time to show appreciation and gratitude for a job well done.

Vituity has opportunities at 900 practices across the country, serving 14.5+ million patients a year. With Vituity, if you ever need to move, you can take your job with you.

• Review and analyze medical records and documentation to ensure accurate coding and billing
• Assign appropriate ICD-10-CM, CPT, and HCPCS Level II codes to diagnoses and procedures for sleep medicine services (e.g., polysomnography, home sleep apnea testing, MSLT, MWT)
• Query providers for clarification when clinical documentation does not support accurate code assignment
• Apply CMS National Correct Coding Initiative (NCCI) edits and payer-specific coverage policies (LCD/NCD) to ensure compliant code selection
• Maintain current knowledge of annual ICD-10-CM, CPT, and HCPCS code-set updates and sleep medicine coding guidelines
• Maintain confidentiality of patient information in accordance with HIPAA regulations
• Verify patient insurance coverage and obtain necessary authorizations for services
• Prepare and submit claims to insurance companies for reimbursement
• Follow up on unpaid or denied claims and resolve any billing discrepancies
• Interpret Explanation of Benefits (EOB) and remittance advice to resolve payment discrepancies and identify denial trends
• Collaborate with medical office staff to ensure accurate and timely billing processes

• High school diploma or GED required.
• Minimum of 2 years of experience in medical billing and/or medical coding, including diagnosis and procedure code assignment Required.
• Proficiency in medical terminology and coding systems, including ICD-10-CM, CPT, and HCPCS Level II, and billing/practice-management software required.
• Certified Professional Coder (CPC) or Certified Billing and Coding Specialist (CBCS) certification preferred.
• Experience coding and billing for sleep medicine or pulmonary specialty services (e.g., polysomnography, home sleep apnea testing, MSLT, MWT) preferred.
• Associate's degree in health information technology, medical billing and coding, or a related field preferred.
• Knowledge of medical collection practices and procedures
• Strong attention to detail and accuracy in coding and billing processes
• Excellent communication skills to interact with patients, insurance companies, and healthcare providers
• Ability to work independently and prioritize tasks in a fast-paced…