coding specialist

Bridge

<div>
 
 
 JOB DESCRIPTION:
 
 
 
 
 
 
 We are seeking a detail-oriented and experienced RCM Coding Specialist with CPC (Certified Professional Coder) certification to join our Revenue Cycle Management team. This role is responsible for accurate and timely medical coding in accordance with current coding guidelines, payer requirements, and company standards. The ideal candidate has strong analytical skills, in-depth knowledge of CPT, ICD-10, and HCPCS codes, and a commitment to ensuring compliance and optimizing reimbursement.&nbsp;
 
 
 
 
 
 
 ESSENTIAL FUNCTIONS:
 
 
 
 
 
 
 ● Serve as an medical coding subject matter expert who can effectively work with other staff to impart best practices related to revenue cycle management/coding within a telehealth setting.
 
 
 ● Review and abstract clinical documentation to assign appropriate CPT, ICD-10, and HCPCS codes.
 
 
 ● Ensure coding accuracy to optimize reimbursement while maintaining compliance with federal regulations, payer policies, and internal protocols.
 
 
 ● Perform regular audits of coded data to ensure quality and identify opportunities for education or process improvement.
 
 
 ● Stay current with industry changes including coding updates, payer guidelines, and regulatory requirements (e.g., CMS, HIPAA).
 
 
 ● Support RCM team in coding-related appeals or re-submissions.
 
 
 ● Maintain strict confidentiality of all patient, provider, and organizational data.
 
 
 ● Identifies problem areas and trends encountered while working with any team or department and communicates findings to management.
 
 
 ● Remains proficient in the use of specific applications related to the coding team&rsquo;s function, i.e. billing systems, EMRs, internal portals, team communication tools, etc.
 
 
 ● Other duties as assigned.&nbsp;
 
 
 
 
 
 
 EDUCATION &amp; EXPERIENCE:
 
 
 
 
 
 
 ● Certification Required: CPC/CPC-A (Certified Professional Coder) from AAPC. Additional certifications (e.g., CRC, CPC-H) are a plus.
 
 
 ● Experience: Minimum 2&ndash;3 years of professional coding experience, preferably in a Revenue Cycle Management setting. ● Education: High school diploma or equivalent required.
 
 
 ● Strong knowledge of medical terminology, anatomy, and physiology.
 
 
 ● Strong organizational and time management skills with attention to detail.
 
 
 ● Proficient in CPT, ICD-10, and HCPCS coding systems.
 
 
 ● Experience with Candid Health billing software is a plus.
 
 
 
 
 
 
 KNOWLEDGE, SKILLS &amp; ABILITIES:
 
 
 
 
 
 
 ● Intermediate knowledge of revenue cycle processes and best practices
 
 
 ● Prior experience with coding audits or quality assurance processes.
 
 
 ● Ability to prioritize work and manage time efficiently
 
 
 ● Self-motivated, able to work autonomously, multi-task and switch focus quickly
 
 
 ● Strong organizational skills and attention to detail
 
 
 ● Ability to meet deadlines
 
 
 ● Ability to apply good judgment and expertise
 
 
 ● Excellent written and verbal communication skills
 
 
 ● Experience in multiple specialties
 
 
 
 
 
 
 COMPENSATION:
 
 
 <ul>
 <li>
 The base pay range for this role is $26 - $30 per hour.
 </li>
 </ul>
</div>

Coding Specialist

Signature Healthcare

<div><div><div><div><div>POSITION SUMMARY:
Under the general direction of the Coding Compliance Manager the Outpatient Coding Specialist is responsible for coding and abstracting services for the full range of hospital services. Reviews diagnosis and diagnostic information and codes and abstracts diagnoses and/or surgical procedures outpatient services, and/or emergency room records using ICD 10 CM and CPT 4 coding classification systems. Ensures ethical and accurate coding in accordance with all regulatory requirements and AHIMA Standards of Ethical Coding.</div> 
</div>
</div></div> 
Location: Signature Healthcare &middot; Health Information Management 
Schedule: Full Time 40 Hours only, Days 1st Shift, flexible</div>

Outpatient Coding Specialist

ExamWorks

<div>
 
 Exam Works is looking for a Medical Coding Specialist to join our team remotely!
 
 
 
 <ul>
 <li>
 Must possess current coding certification in CPC. CPMA certification &amp; Certified Life Care Planner certification preferred.
 
 
 </li>
 </ul>
 The
 
 Medical Coding Specialist
 
 (Internally called a Coding Specialist) is responsible to create and write reports based on medical records and appropriate guideline criteria. This position utilizes the system database to determine usual and customary and/or state fee schedule allowances and this position is responsible for analyzing provider billing for proper coding and billing guidelines across all provider types and ensures reviews are completed with highest quality and integrity and that all work is in full compliance with client contractual agreements, regulatory agency standards and/or federal and state mandates.
 
 
 Schedule for this role is:
 
 Monday - Friday 8am-5pm EST
 
 
 
 
 Essential Job Functions
 
 
 
 <ul>
 <li>
 Receive and input client and examinee data in the system database.
 </li>
 <li>
 Sort and verify each claim.
 </li>
 <li>
 Process and review each claim and address all necessary modifications manually. Contact Client as needed
 </li>
 <li>
 Perform quality assurance on every case prior to completion.
 </li>
 <li>
 Ensure all medical records and reports are properly documented and saved in the appropriate location and available for audit at all times.
 </li>
 <li>
 Process client invoicing in accordance with the client&rsquo;s fee schedule.
 </li>
 <li>
 Handle and responds promptly to incoming calls, emails or faxes from clients requesting report status and/or information.
 </li>
 <li>
 Provide notification to the Supervisor of any provider appeals and follow directions as given to resolve the claim.
 </li>
 <li>
 Provide testimony in court as to the content of prepared reports, as required. Travel as necessary.
 </li>
 <li>
 Ensure all practices are carried out in accordance with HIPAA compliance practices, state and federal safety standards and legal regulations.
 </li>
 <li>
 Perform quality assurance on various coding related reviews.
 </li>
 <li>
 Perform other duties as assigned.
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 
 Education and/or Experience
 
 
 
 <ul>
 <li>
 High school diploma or equivalent required.
 </li>
 <li>
 Minimum one year medical billing experience; or equivalent combination of education and experience required.
 
 
 </li>
 </ul>
 
 Certificates, Licenses, Registrations
 
 
 
 
 Must Possess Current Coding Certification In
 
 
 
 <ul>
 <li>
 OASIS, RAC-CT, CCS, CPC, RHIT or RHIA. CPMA certification preferred.
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 <ul>
 <li>
 Must have minimum of one year medical billing experience; or equivalent combination of education and experience required.
 </li>
 <li>
 Must have a full understanding of aspects of medical billing.
 </li>
 <li>
 Must demonstrate understanding of the various types of medical billings and ability to identify which system database should be used.
 </li>
 <li>
 Must be able to cross reference different types of billings to ensure consistency in the review process.
 </li>
 <li>
 Must possess knowledge of standard fee schedule review, UC&amp;R review, drug and supply charges, rarity, utilization review, CPT guidelines, ICD 10, bundling/unbundling, duplicate billing and CMS reimbursement guidelines.
 </li>
 <li>
 Must possess complete knowledge of general computer, fax, copier, scanner, and telephone.
 </li>
 <li>
 Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
 </li>
 <li>
 Must have a full understanding of HIPAA regulations and compliance.
 </li>
 <li>
 Must be a qualified typist with a minimum of 35 W.P.M.
 </li>
 <li>
 Ability to follow instructions and respond to managements&rsquo; directions accurately.
 </li>
 <li>
 Ability to work independently, prioritize work activities and use time efficiently.
 </li>
 <li>
 Must be able to maintain confidentiality.
 </li>
 <li>
 Must be able to demonstrate and promote a positive team -oriented environment.
 </li>
 <li>
 Must be able to stay focused and concentrate under normal or heavy distractions.
 </li>
 <li>
 Must be able to work well under pressure and or stressful conditions.
 </li>
 <li>
 Must possess the ability to manage change, delays, or unexpected events appropriately.
 </li>
 <li>
 Ability to follow all company policies and procedures in effect at time of hire and as they may change or be added from time to time.
 
 
 </li>
 </ul>
 
 ExamWorks
 
 is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages.
 
 
 
 ExamWorks, LLC
 
 is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.
 
 
 
 Equal Opportunity Employer - Minorities/Females/Disabled/Veterans
 
 
 
 
 
 ExamWorks offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.
 
 
 
 
 TAGS
 
 
 CPC, CPMA, Medical Billing, Medical Billing Specialist
</div>

Medical Coding Specialist (31620)

Mitchell County Health Dept

<div>
 
 Who We Are
 
 
 
 Mitchell County Regional Health Center is in Osage, Iowa located in Mitchell County, which has a population of 10,600 people. MCRHC is a 25-bed critical access hospital, including a Level 4 Trauma Center Emergency Room seeing 3,200 visits annually. The Surgical Services department performs over 1,300 procedures annually, including specialties General Surgery, Orthopedics, ENT, Urology, Ophthalmology, Pain management, and Podiatry.
 
 
 We are proud to share our strong tradition of excellence, progress and solid economic performance. Founded more than 75 years ago as a community hospital, today we operate three clinics, 24/7 emergency services, inpatient and outpatient medical/surgical services. We have invested millions in facility upgrades just in the last few years. With more than 225 employees and average tenure of eight years, our growth continues with multiple expansion projects currently underway. We are an affiliate of MercyOne.
 
 
 Come practice in a family-oriented, patient focused organization where your skills and knowledge are appreciated and valued!
 
 
 
 About The Job
 
 
 
 Seeking a detail-oriented Inpatient/Surgery/ProFee medical coder to help ensure the delivery of excellent healthcare services. The ideal candidate will have thorough knowledge of anatomical and medical terminology, as well as natural curiosity and an analytical mindset. Responsibilities will include reviewing patient records, lab results, operative reports and other physician documentation to determine accurate ICD-10-CM, CPT, and HCPCS codes to ensure compliant billing for insurance reimbursement and facility revenue. Also coding professional charges (hospital rounds, clinic visits, etc.). Other responsibilities include collaborating with physicians for clarification, providing physician education, and maintaining confidentiality. The medical coder will adhere to standard protocols of the profession while using their own methods to compile the most accurate information and promote organizational growth. Opportunity to work remotely after working onsite for one year.
 
 
 
 The Position:
 
 1.0 FTE. 80 hours per pay period. Monday-Friday. Flexible Hours
 
 
 
 Pay:
 
 Starts at $20.27, increase with experience.
 
 
 
 Position Qualifications
 
 
 
 <ul>
 <li>
 Education:
 </li>
 <ul>
 <li>
 Courses in medical terminology, , ICD-10 and CPT coding, anatomy and physiology and pharmacology.
 </li>
 <li>
 Coding Certification preferred.
 </li>
 </ul>
 <li>
 Experience:
 </li>
 <ul>
 <li>
 At least two years of relevant health care experience or one year experience in CPT and ICD-10 coding systems preferred
 </li>
 </ul>
 <li>
 Special Skills, Competencies, and Aptitudes:
 </li>
 <ul>
 <li>
 Must possess good interpersonal communication skills and be able to interact with a variety of customers including providers.
 </li>
 <li>
 Typing &amp; computer skills.
 
 </li>
 </ul>
 </ul>
 
 What We Give
 
 
 
 <ul>
 <li>
 Paid Time Off
 </li>
 <li>
 Competitive starting wage
 </li>
 <li>
 Student Loan Assistance program available
 </li>
 <li>
 Health, Dental and Life Insurance
 </li>
 <li>
 State of Iowa Pension Plan (IPERS)
 </li>
 <li>
 Flex Spending Accounts
 </li>
 <li>
 Free use of on-site gym
 </li>
 <li>
 Cafeteria Discounts
 </li>
 <li>
 Optometry and Orthotic Discounts
 </li>
 <li>
 Professional Development Opportunities
 
 
 </li>
 </ul>
 
 The Legal Items
 
 
 
 <ul>
 <li>
 Reference Checks-Pre-Offer
 </li>
 <li>
 Post offer drug screen is required
 </li>
 <li>
 Background Check-Post Offer Acceptance
 </li>
 <li>
 Pre-Employment Screening Post offer acceptance
 </li>
 <li>
 MCRHC is an equal opportunity employer
 </li>
 <li>
 Verification of required vaccinations at offer acceptance. MMR, Tetanus and Varicella
 </li>
 </ul>
</div>

Mercyhealth

<div>ESSENTIAL DUTIES AND RESPONSIBILITIES<ul><li>
Reviews, analyzes, and interprets provider documentation with regards to procedure and diagnosis code selection.</li><li>
Performs audits of provider coding and documentation to make recommendations for improvements and enhancements.</li><li>
Maintains a close working relationship with assigned providers and medical office, frequently querying the provider when coding discrepancies arise.</li><li>
Researches any coding inquiries the provider or medical staff may have, and presents findings to them.</li><li>
Reviews hospital, clinical, and surgical documentation and the assigned diagnosis and procedure codes, releasing charges within the Epic system. Identifies discrepancies between the provider code selection and the medical record documentation; makes appropriate corrections, and presents findings and education to the provider.</li><li>
Demonstrates extensive knowledge of official coding guidelines established by the American Medical Association (AMA), the Center for Medicare &amp; Medicaid Services (CMS) and contracted payers.</li><li>
Has a thorough understanding of the differences between professional coding in a clinic setting as compared to professional coding in a hospital setting (outpatient and inpatient), and demonstrates a high skill level in the practical application of that knowledge.</li><li>
Works with billing partners in developing efficient coding processes and researching denials.</li><li>
Responds to customer concerns through coding reviews requested by other departments.</li><li>
Conducts provider coding orientation and education sessions and documents all information presented.</li><li>
Maintains an in-depth knowledge of Epic ambulatory and hospital modules.</li><li>
Works as a team to achieve productivity goals.</li></ul>
EDUCATION AND EXPERIENCE
High School graduate or equivalent 
Two years of experience coding professional services in multiple specialties
CERTIFICATION AND LICENSURE
Certified Professional Coder (CPC) or other equivalent coding certification required 
SKILLS AND ABILITIES 
Problem solving skills 
Excellent written/oral/interpersonal/communication skills 
Analytical skills 
 
SPECIAL PHYSICAL DEMANDS
The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations. 
While performing the duties of this job, the partner is regularly required to talk and hear. Eyesight to identify numbers, folders, colors, and computer printouts. Speech to communicate one-on-one and over the telephone. Manual dexterity to operate keyboards, mouse and telephones. Prolonged sitting; use hands to finger, handle, or feel and reach with hands and arms. The partner is occasionally required to stand; walk and stoop, kneel, crouch, or crawl. The partner must occasionally lift and/or move up to 25 pounds.
LEVEL OF SUPERVISION
N/A
SUPERVISES
N/A
PAY RANGE:
$24.12 - $36.18
Mercyhealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or protected veteran status.
Mercyhealth offers competitive pay and a comprehensive benefits package including:
<ul><li>Medical, Dental, Vision</li><li>
Life &amp; Disability Insurance</li><li>
FSA/HSA Options</li><li>
Generous, accruing paid time off</li><li>
Paid Parental and caregiver leave</li><li>
Career advancement and educational opportunities</li><li>
Tuition and certification reimbursement</li><li>
Certification Reimbursement</li><li>
Well-being Programs</li><li>
Employee Discounts</li><li>
On-Demand Pay</li><li>
Financial Education</li><li>
Annual recognition/awards events</li><li>
Partner appreciation days</li><li>
Family entertainment/attractions discount</li><li>
Community service/improvement opportunities</li></ul>
Click here for more details regarding Mercyhealth Careers Benefit Information.
At Mercyhealth, we don&rsquo;t simply hire people, we empower employee-partners who are passionate about making lives better. As an integrated health system, we deliver exceptional, coordinated across seven hospitals, 85 primary and specialty clinics, and a team of over 7,500 professionals serving northern Illinois and southern Wisconsin.
Mercyhealth has been nationally recognized for our commitment to our people and culture, including:
<ul><li>#1 in the nation on AARP's Best Employers for Workers Over 50</li><li>
One of Working Mother magazine's 100 Best Companies for Working Mothers</li><li>
A Top 50 Company and Top 10 Nonprofit for Executive Women</li></ul></div>

Medical Coding Specialist 2

<div>Essential Duties and Responsibilities 
<ul><li>
Reviews, analyzes, and interprets provider documentation with regards to procedure and diagnosis code selection.</li><li>
Performs audits of provider coding and documentation to make recommendations for improvements and enhancements.
</li><li>Maintains a close working relationship with assigned providers and medical office, frequently querying the provider when coding discrepancies arise.</li><li>
Researches any coding inquiries the provider or medical staff may have, and presents findings to them.</li><li>
Reviews hospital, clinical, and surgical documentation and the assigned diagnosis and procedure codes, releasing charges within the Epic system. Identifies discrepancies between the provider code selection and the medical record documentation; makes appropriate corrections, and presents findings and education to the provider.</li><li>
Demonstrates extensive knowledge of official coding guidelines established by the American Medical Association (AMA), the Center for Medicare &amp; Medicaid Services (CMS) and contracted payers.</li><li>
Has a thorough understanding of the differences between professional coding in a clinic setting as compared to professional coding in a hospital setting (outpatient and inpatient), and demonstrates a high skill level in the practical application of that knowledge.</li><li>
Works with billing partners in developing efficient coding processes and researching denials.</li><li>
Responds to customer concerns through coding reviews requested by other departments.</li><li>
Conducts provider coding orientation and education sessions and documents all information presented.</li><li>
Maintains an in-depth knowledge of Epic ambulatory and hospital modules.</li><li>
Works as a team to achieve productivity goals.</li></ul> 

Culture of Excellence Behavior Expectations 
To perform the job successfully, an individual should demonstrate the following behavior expectations:
 
 
Quality - Follows policies and procedures; adapts to and manages changes in the environment; Demonstrates accuracy and thoroughness giving attention to details; Looks for ways to improve and promote quality; Applies feedback to improve performance; Manages time and prioritizes effectively to achieve organizational goals. 
 
Service - Responds promptly to requests for service and assistance; Follows the Mercyhealth Critical Moments of service; Meets commitments; Abides by MH confidentiality and security agreement; Shows respect and sensitivity for cultural differences; and effectively communicates information to partners; Thinks system wide regarding processes and functions. 
 
Partnering - Shows commitment to the Mission of Mercyhealth and Culture of Excellence through all words and actions; Exhibits objectivity and openness to other's views; Demonstrates a high level of participation and engagement in day-to-day work; Gives and welcomes feedback; Generates suggestions for improving work: Embraces teamwork, supports and encourages positive change while giving value to individuals. 
 
Cost - Conserves organization resources; Understands fiscal responsibility; Works within approved budget; Develops and implements cost saving measures; contributes to profits and revenue. 
Education and Experience 
High School graduate or equivalent 
Two years of experience coding professional services in multiple specialties 
Certification and Licensure 
Certified Professional Coder (CPC) or other equivalent coding certification required 
Skills and Abilities 
Problem solving skills 
Excellent written/oral/interpersonal/communication skills
 
Analytical skills
 
 
Special Physical Demands 
The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations. 
While performing the duties of this job, the partner is regularly required to talk and hear. Eyesight to identify numbers, folders, colors, and computer printouts. Speech to communicate one-on-one and over the telephone. Manual dexterity to operate keyboards, mouse and telephones. Prolonged sitting; use hands to finger, handle, or feel and reach with hands and arms. The partner is occasionally required to stand; walk and stoop, kneel, crouch, or crawl. The partner must occasionally lift and/or move up to 25 pounds. 
 
 
Level of Supervision 
N/A 
Supervises 
N/A
PAY RANGE:
$24.12 - $36.18
Mercyhealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or protected veteran status.
Mercyhealth offers competitive pay and a comprehensive benefits package including:
<ul><li>Medical, Dental, Vision</li><li>
Life &amp; Disability Insurance</li><li>
FSA/HSA Options</li><li>
Generous, accruing paid time off</li><li>
Paid Parental and caregiver leave</li><li>
Career advancement and educational opportunities</li><li>
Tuition and certification reimbursement</li><li>
Certification Reimbursement</li><li>
Well-being Programs</li><li>
Employee Discounts</li><li>
On-Demand Pay</li><li>
Financial Education</li><li>
Annual recognition/awards events</li><li>
Partner appreciation days</li><li>
Family entertainment/attractions discount</li><li>
Community service/improvement opportunities</li></ul>
Click here for more details regarding Mercyhealth Careers Benefit Information.
At Mercyhealth, we don&rsquo;t simply hire people, we empower employee-partners who are passionate about making lives better. As an integrated health system, we deliver exceptional, coordinated across seven hospitals, 85 primary and specialty clinics, and a team of over 7,500 professionals serving northern Illinois and southern Wisconsin.
Mercyhealth has been nationally recognized for our commitment to our people and culture, including:
<ul><li>#1 in the nation on AARP's Best Employers for Workers Over 50</li><li>
One of Working Mother magazine's 100 Best Companies for Working Mothers</li><li>
A Top 50 Company and Top 10 Nonprofit for Executive Women</li></ul></div>

Medical Coding Specialist

Empowerment Resource Center

<div><div>Job Classification: Billing &amp; Coding Specialist</div><div>
Reports To: Client Services Supervisor</div><div>
FLSA Status: Part -Time not to Exceed 29 Hours week</div><div></div><div> 
Summary: Reports to the Client Services Supervisor. The Billing &amp; Coding Specialist is responsible for managing the end-to-end medical billing process, including claim submission, payment posting, denial resolution, and reconciliation across EMR and QuickBooks systems and payer compliance to ensure timely and accurate revenue collection for the organization. . This position ensures compliance with payer contracts and coding standards, promotes accurate reimbursements, and supports financial transparency. The role plays a vital part in maintaining the organization&rsquo;s financial health, improving cash flow, and ensuring alignment with private insurance carrier agreements.</div><div></div><div> 
The Billing &amp; Coding Specialist must have a strong understating of CPT, ICD-10 and insurance billing codes, as well as, working knowledge of payer contracts, private carrier reimbursement methodologies, and compliance requirements, The incumbent ensures that all claims are processed correctly, reimbursement are maximized, and revenue is maintained through careful monitoring, auditing, and collaboration with internal departments and payers. The role supports and enhances the insurance billing function through diligent claim management, payer communication, and reconciliation activities that promote accurate reimbursement and financial transparency.</div><div></div><div> 
Essential Duties and Responsibilities:</div><div></div><h1 class="jobSectionHeader"> 
Insurance Claims Management</h1><div><ul><li>
Verify CPT codes prior to claim submission in the EMR system to ensure compliance and maximize reimbursement.</li><li>
Collaborate with coding and revenue cycle teams to resolve complex CPT coding issues beyond standard expertise.</li><li>
Prepare, review, and submit insurance claims through the EMR system, ensuring compliance with payer-specific and contractual requirements.</li><li>
Monitor and manage claim submissions to ensure accuracy, timely filing, and proper follow-up on rejections or denials.</li><li>
Research claim denials and rejections, determine root causes, and take corrective actions to resolve issues promptly.</li><li>
Revise and resubmit corrected claims with necessary documentation and coding updates to secure proper reimbursement.</li><li>
Participate in weekly meetings with clinic leadership to analyze denials, rejections, and claim status for continuous improvement.</li><li>
Monitor the adjudication of submitted claims to verify timely processing, accuracy, and alignment with contracted reimbursement rates.</li><li>
Represent and advocate for corrected or underpaid claims during follow-up with insurance carriers.</li><li>
Ensure all billing activities comply with payer contracts, including fee schedules, covered services, and filing deadlines established by private carriers.</li></ul>
Payment Processing<div><ul><li>
Post all insurance payments&mdash;checks, ACH, and virtual card payments&mdash;into the EMR system, ensuring proper allocation to patient accounts.</li><li>
Collaborate with Accounts Receivable (A/R) to review outstanding claims, address aged accounts (91+ and 121+ days), and ensure all posted payments are reflected accurately.</li><li>
Track unpaid claims, follow up with insurance companies, and execute collection procedures on delinquent accounts to minimize write-offs.</li><li>
Pull and review A/R reports regularly to identify trends, payment delays, or discrepancies</li></ul></div>
Contract Compliance and Payer Relations<div><ul><li>
Maintain up-to-date knowledge of payer contracts, reimbursement terms, and policy changes for private carriers.  Verify that all claims, payments, and adjustments adhere to negotiated fee schedules and contractual obligations.</li><li>
Identify and report patterns of underpayment or contract violations by payers to management.</li><li>
Assist leadership with payer audits, renegotiations, and periodic reviews to ensure continued compliance and optimal reimbursement.</li><li>
Serve as a liaison between the organization and private insurance carriers to promote positive working relationships and resolve contract-related billing concerns.</li><li>
Participate in regular meetings with A/R and billing support teams to align on claim status, outdated accounts, and reconciliation needs.</li><li>
Communicate professionally with insurance representatives, patients, and internal teams to facilitate timely resolutions and optimize reimbursement workflows.</li></ul></div>
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.<div><ul><li>
Education and/or Experience: High school diploma or equivalent required; Associate&rsquo;s or Bachelor&rsquo;s degree in Healthcare Administration, Accounting, or related field preferred. 2+ years of experience in medical billing, insurance claims, or accounts receivable management required. Proficiency in EMR systems. Strong understanding of CPT, ICD-10, and insurance billing codes (certified coder preferred but not required). Working knowledge of payer contracts, private carrier reimbursement methodologies, and compliance requirements. Excellent organizational, analytical, and problem-solving skills. Strong communication skills and attention to detail.</li><li>
Certifications, Licenses, Registrations: Certified coder preferred, but not required.</li><li>
Language Skills: Fluency in English and Spanish is preferred. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, participants, funders, and the general public.</li><li>
Computer Skills: Must possess extensive computer skills and experience with software use (Word, Excel, PowerPoint, Publisher, Adobe, etc.). Must be proficient in Microsoft Office Suite; Electronic mail software; Microsoft Exchange. Medical software &ndash; Electronic medical/health records software and Client management software. Helpful if you have experience in Greenway, and any Telemedicine platform. Knowledge of Quest and LabCorp systems.</li><li>
Mathematical Skills: Basic math, bookkeeping and accounting skills.</li><li>
Reasoning Ability: Effective computer skills to use bookkeeping and account management software in a timely and efficient manner. Strong communication, including writing, speaking and active listening. Must be a great communicator, meticulous, and possess excellent interpersonal skills. Great customer service skills, including interpersonal conversation, patience and empathy. Good problem-solving and critical thinking skills. Organization, time management and prioritization abilities. Ability to be discreet and maintain the security of patient or customer information. Understanding of industry-specific policies, such as HIPAA regulations for health care. Demonstrate the ability to exercise discretion, independent judgment, and business acumen. Exhibit the finesse to handle private, confidential, protected, and sensitive information. Possess a genuine empathy for clients and a willingness to help others. Possess excellent communication skills and the tact to deal effectively with clients, guests, program staff, medical and behavioral health professionals, and executive-level staff. Must have the ability to interact with professional staff and clients from diverse socioeconomic background, races, and cultures. Must have the ability to conduct Internet research. Must possess strong leadership, team-building, management, organizational, and time management skills. Must possess the ability to develop innovative action plans to improve efficiency and processes, minimize cost/waste, and meet quality standards.</li></ul></div></div><div> 
Employment Standards &amp; Conditions: Must successfully pass a pre-employment drug screen and background check.
Must be able to work flexible hours when required.
Must submit verification of completion of the following current health screenings:
Influenza immunization
Tuberculin Skin Test (TB) within the past 12 months
HBV immunization (required if position requires direct contact with clients) 
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk and hear.
The employee is regularly required to sit, stand and walk.
The employee s regularly required to use hands to key, handle, or feel and reach with hands and arms.
The employee must occasionally lift and/or move up to 25 pounds. 
Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is moderate.
Empowerment Resource Center (ERC) values a diverse, respectful, and collaborative work environment. We establish and maintain trustful relationships with our staff, partners, funders, and the communities that we are privileged to serve. ERC makes all hiring and employment decisions without regard to race, creed, color, age, gender, gender identity, marital or parental status, religion, ancestry, national origin, physical or mental disability, sexual orientation, sexual identity, immigrant status, political affiliation or belief, exoffender status (depending on the offense and position to be filled), and/or unfavorable military discharge.</div></div>

Billing & Coding Specialist

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