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Coding and Billing Specialist

Medical Billing and CodingMedical Billing and CodingOtherRemoteMid LevelTeam 201-500

Location

United States

Posted

80 days ago

Salary

0

Seniority

Mid Level

Job Description

Coding and Billing Specialist

firsthand Health

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Coding & Billing Specialist is a critical, full-time, salaried position within firsthand’s clinical documentation team. This role is a foundational hire, offering the opportunity to define key processes and program elements for comprehensive and accurate coding of clinical services. Key Responsibilities - Coding & Auditing: - Perform day-to-day encounter coding for services, procedures, diagnoses, and treatments. - Verify that all assigned codes (ICD, CPT, and HCPC) are compatible, appropriate, and accurate for billing. - Audit clinical notes for supporting documentation and code to the highest specificity. - Use medical terminology to confirm clinical documentation supports the reported diagnoses. - Conduct coding corrections. - Claims & Revenue Cycle Management: - Prepare and submit claims for payment. - Correct and resubmit rejected claims. - Maintain Accounts Receivable (A/R) for revenue cycle management. - Expertise & Process Improvement: - Serve as the subject matter expert on firsthand's billing systems, including the Electronic Health Record (EHR) and Clearinghouses. - Advise on and implement ongoing process improvements related to coding and billing. - Develop and update procedures manuals to ensure correct coding standards and minimize fraud/abuse risk (e.g., revising the master CPT list). - Education & Support: - Educate firsthand Advanced Practice Nurses (APNs), Nurse Practitioners (NPs), and other team members on proper code selection, documentation, procedures, and requirements. - Provide technical guidance to clinical staff in resolving coding issues, such as incomplete or ambiguous documentation. Qualifications - 4+ years of experience as a medical billing and coding specialist, leveraging an EHR system. - A High School diploma or equivalent. - Required Medical Coder Certification: - Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist (CCS) from AHIMA. - Nice-to-have: - Certified Risk Adjustment Coder (CRC) from AAPC. Requirements - Strong knowledge of ICD-10-CM and CPT coding guidelines. - Proficiency in medical terminology, with the ability to read and interpret medical procedures and documentation. - Expertise in state and federal Medicare reimbursement guidelines. - Ability to quickly gain proficiency in firsthand’s specific EHR, Clearinghouse, and other billing software. - Strong multi-tasking skills and consistent attention to detail. - Excellent written and verbal communication skills for maintaining collaborative relationships with APNs, NPs, the Clinical Documentation Integrity Specialist, and other team members. - Support firsthand’s mission, vision, and values by demonstrating respect, dignity, empathy, and professional conduct. Benefits - Base salary range: $55,000 - $55,000 USD. - Compensation package includes base, equity (or a special incentive program for clinical roles), and performance bonus potential. - Benefits include physical and mental health, dental, vision, 401(k) with a match. - 16 weeks parental leave for either parent. - 15 days/year vacation in your first year (this increases to 20 days/year in your second year and beyond). - A supportive and inclusive culture.

Job Requirements

  • 4+ years of experience as a medical billing and coding specialist, leveraging an EHR system.
  • A High School diploma or equivalent.
  • Required Medical Coder Certification: Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist (CCS) from AHIMA.
  • Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist (CCS) from AHIMA.
  • Nice-to-have: Certified Risk Adjustment Coder (CRC) from AAPC.
  • Certified Risk Adjustment Coder (CRC) from AAPC.
  • Strong knowledge of ICD-10-CM and CPT coding guidelines.
  • Proficiency in medical terminology, with the ability to read and interpret medical procedures and documentation.
  • Expertise in state and federal Medicare reimbursement guidelines.
  • Ability to quickly gain proficiency in firsthand’s specific EHR, Clearinghouse, and other billing software.
  • Strong multi-tasking skills and consistent attention to detail.
  • Excellent written and verbal communication skills for maintaining collaborative relationships with APNs, NPs, the Clinical Documentation Integrity Specialist, and other team members.
  • Support firsthand’s mission, vision, and values by demonstrating respect, dignity, empathy, and professional conduct.

Benefits

  • Base salary range: $55,000 - $55,000 USD.
  • Compensation package includes base, equity (or a special incentive program for clinical roles), and performance bonus potential.
  • Benefits include physical and mental health, dental, vision, 401(k) with a match.
  • 16 weeks parental leave for either parent.
  • 15 days/year vacation in your first year (this increases to 20 days/year in your second year and beyond).
  • A supportive and inclusive culture.

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