Medical Billing & Collections Specialist | Full-time | Remote At H2 Health, we understand that efficient billing and collections are vital to ensuring our patients receive the best care without financial barriers.  Join H2 Health's revenue cycle team, where accuracy and efficiency drive our mission to support outstanding healthcare delivery. At H2 Health, we’re clinician-led and people-focused, with a commitment to clean systems, clear expectations, and no-nonsense transparency. If you’re passionate about supporting patient care behind the scenes, this is your opportunity to make a difference. Your Role: In this role, you'll be responsible for overseeing the entire billing lifecycle, from claim submission through collections, while maintaining strong communication with patients and payers. - Submit timely and accurate medical claims to third-party payers (including Medicare, Medicaid, and commercial insurances) - Process billing for Physical Therapy (PT) and Applied Behavior Analysis (ABA) services across multiple locations - Monitor and follow up on outstanding accounts receivable to ensure prompt payment - Research and resolve billing issues, denials, and rejected claims - Post patient payments, refunds, and adjustments; ensure proper ledger documentation - Maintain detailed notes in patient accounts per internal policy and billing procedures - Respond to patient or payer inquiries related to account balances - Support clean claim processes by flagging fee schedule discrepancies or data entry errors - Collaborate with internal teams to clarify documentation, authorizations, and payer requirements - Maintain compliance with HIPAA and internal confidentiality standards

• Accurately code complex surgical procedures across assigned specialties • Ensure compliance with CMS, payer policies, and coding guidelines • Apply appropriate modifiers and resolve bundling issues • Review operative notes and clinical documentation for coding accuracy • Support denial reduction through accurate and compliant coding practices • Maintain productivity and quality benchmarks as per organizational standards

• Provides accurate and timely assignment of appropriate ICD-10 diagnostic and PCS procedural codes on the medical records for the purpose of collecting and indexing quality health information for inpatient hospital encounters. • Reviews the medical record, identifies the diagnoses and procedures, and assigns ICD-10-CM diagnosis and ICD-10 PCS procedure codes for inpatient accounts. • Abstracts diagnostic and PCS procedural codes and other pertinent data into the network system as defined in policy and procedures. • Reviews/monitors assigned work queues and missing documentation encounters as needed, and codes and abstracts any accounts that were missed. • Provides information on specific problem accounts to the Coding Supervisor. • Other duties as assigned.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description As a key member of the Amazon One Medical Revenue Cycle team, the Coding Compliance Auditing Manager will be responsible for supporting Amazon One Medical Clinical and Revenue Cycle teams in managing and optimizing compliant healthcare revenue cycle operations. - Lead a team of coding compliance auditors, ensuring accurate medical coding practices and maintaining compliance with regulatory requirements. - Demonstrate increased autonomy and strategic thinking and problem-solving skills. - Manage, mentor, and develop a team of coding compliance auditors. - Establish performance standards, metrics, audit schedules, comprehensive audit protocols, and monitor coding accuracy rates. - Coordinate workload distribution and maintain productivity standards. - Provide ongoing feedback, education, and training to team members. - Provide guidance on challenging coding scenarios and ensure adherence to ICD-10-CM, CPT, and HCPCS coding guidelines. - Monitor and stay current with updates to coding regulations and implement necessary changes. - Maintain documentation of audit findings and corrective actions. Qualifications - 3+ years of direct leadership/supervisory experience. - Bachelor's degree in Healthcare, Business, Human Resources, or related field. - 5+ years of coding/auditing experience in the professional fee and/or risk adjustment setting working with Medicare, Medicare Advantage, and Commercial payers required. - Knowledge of industry standard code sets and associated guidelines (ICD-10-CM, CPT, HCPCS). - Possesses advanced knowledge and understanding of HCC Risk Adjustment, coding and documentation requirements. - CPC certification through AAPC and/or CCS certification through AHIMA required. - CPMA and CRC certification through AAPC required. Requirements - Experience in project management including resource planning, managing schedules, reporting project status and prioritizing own tasks and those of other team members for multiple projects. - Strong analytical skills, attention to detail, and effective communication abilities. - Experience working proactively and independently, meeting deadlines, and delivering on projects and tasks. - Ability to identify and communicate trends in coding and documentation. - Complies with policies and procedures for confidentiality of all patient records and security of systems. Benefits - Comprehensive health insurance (medical, dental, vision, prescription, Basic Life & AD&D insurance and option for Supplemental life plans, EAP, Mental Health Support, Medical Advice Line, Flexible Spending Accounts, Adoption and Surrogacy Reimbursement coverage). - 401(k) matching. - Paid time off. - Parental leave.