• Review clinical documentation to assign appropriate ICD-10, CPT, and HCPCS codes for services rendered • Ensure coding accuracy and compliance with official coding guidelines and payer-specific requirements • Assist in identifying coding trends that may affect revenue or compliance • Perform audits • Query providers when documentation is unclear or insufficient for coding purposes • Monitor and work denial reports or queues to identify and analyze trends in denied or rejected claims • Research root causes of denials including coding errors, missing documentation, or payer-specific issues • Submit timely, well-documented appeals or corrections to payers • Maintain accurate records of denial outcomes and appeal statuses

Role Description We are seeking a detail-oriented and motivated Medical Billing Manager to join our growing healthcare team. This role is responsible for reviewing, researching, and resolving unpaid or denied insurance claims while ensuring accurate and timely reimbursement for medical services rendered. The ideal candidate is highly organized, an effective communicator, and comfortable working independently in a remote yet collaborative environment. - Review and follow up on outstanding medical insurance claims and unpaid balances - Investigate denied or underpaid claims and take corrective action as needed - Communicate with insurance carriers regarding claim status, appeals, eligibility, and payment discrepancies - Submit corrected claims and appeals in a timely manner - Maintain accurate documentation of account activity and follow-up efforts - Work collaboratively with billing, coding, and administrative teams to resolve claim issues - Identify trends in denials and recommend process improvements - Ensure compliance with HIPAA and all applicable healthcare billing regulations - Meet productivity and quality standards while managing multiple accounts and deadlines Qualifications - Certified Professional Coder (CPC) required - Previous experience in medical billing, insurance follow-up, or revenue cycle management preferred - Familiarity with EMR/EHR systems and medical billing software - Knowledge of insurance guidelines, CPT/ICD-10 coding, and payer requirements - Experience handling appeals and claim denials - Current Employees: must have been employed by ResPro for 6 months Preferred Qualifications - Proficient knowledge, skill, and interest in basic computer skills - Strong problem-solving skills with the ability to multi-task effectively - Excellent verbal and written communication skills - Excellent teamwork and collaboration skills - Comfortable working remotely while maintaining strong communication with team members - Strong attention to detail and organizational skills - Ability to work independently and manage priorities efficiently - Clean background check required Benefits - Comprehensive Health Care Plan (Medical, Dental, Vision) - Flexible Paid Time Off - Full Time position with a salary range of $60,000 - $65,000

Role Description At Lifepoint Health, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. As a member of the Lifepoint Business Services (LBS) team, you’ll support those that are in our facilities who are interfacing and providing care to our patients and community members to positively impact our mission of making communities healthier ®. Our LBS Credentialing Support Services team is a highly detail-oriented, collaborative group that plays a critical role in supporting timely provider onboarding and patient care coverage across Lifepoint facilities. Working in a fully remote environment, team members operate with a high degree of independence while partnering closely with peers and facilities to manage urgent priorities, maintain compliance, and drive accurate verification. If you are organized, trustworthy, and motivated by meaningful work, you’ll truly be part of something bigger with this team. A Credentialing Support Services Specialist who excels in this role: - Process initial appointments, reappointments, and privileging applications for physicians and advanced practice providers in accordance with Medical Staff Bylaws, accreditation standards, and organizational policies. - Perform comprehensive primary source verification of licensure, education, training, board certification, work history, professional references, malpractice coverage, sanctions, and other credentialing requirements. - Prepare credentialing files for review by Medical Staff Services leadership, credentialing committees, Medical Executive Committees, and Governing Boards. - Maintain provider credentialing records within MD-Staff and other credentialing systems while ensuring accuracy and regulatory compliance. - Collaborate closely with Medical Staff Professionals, providers, facility leadership, and department stakeholders to obtain required documentation and resolve credentialing deficiencies. - Monitor provider expirables, including licenses, DEA registrations, board certifications, malpractice insurance, and other required credentials to ensure ongoing compliance. - Support privileging activities, including processing delineation of privileges forms and maintaining provider privilege records. - Ensure compliance with Joint Commission, CMS, NCQA, state regulatory requirements, and Medical Staff Bylaws. - Manage multiple credentialing files simultaneously while meeting established turnaround times and service level expectations. - Participate in quality assurance activities, audits, and process improvement initiatives to support credentialing accuracy and operational effectiveness. Qualifications - High school diploma or equivalent, or combination of education and experience required for the job. - Minimum 2 years of provider credentialing experience required; hospital Medical Staff credentialing experience strongly preferred. - Experience credentialing physicians, advanced practice, or other licensed healthcare providers. - Experience performing primary source verification, provider file review, and credentialing compliance activities. - Knowledge of Joint Commission, CMS, NCQA, and Medical Staff credentialing standards preferred. - Experience supporting credentialing committees, Medical Executive Committees, privileging processes, or provider onboarding preferred. - Experience utilizing credentialing systems such as MD-Staff, CredentialStream, Cactus, Symplr, or similar credentialing platforms preferred. - Strong organizational skills with the ability to manage multiple provider files and competing deadlines simultaneously. - Demonstrated ability to work independently in a remote environment while maintaining productivity and quality standards. Benefits - Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees. - Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off. - Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match. - Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs). - Professional Development: Ongoing learning and career advancement opportunities. - Pay range: $20 - $25 per hour. EEOC Statement Lifepoint Health is an Equal Opportunity Employer. Lifepoint Health is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment. Employment Sponsorship Statement You must be authorized to work in the United States without employer sponsorship. Pay Transparency Notice (Washington State) If you believe this job posting does not include accurate or complete pay information in accordance with the Washington State Equal Pay and Opportunities Act, please inform us immediately. You can contact us at 833-271-4269 to report the issue. For more information on your rights under Washington’s pay transparency laws, visit the Washington State Department of Labor and Industries website at: https://lni.wa.gov .

• Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines. • Ensure coding is consistent with ICD-10-CM, CMS-HCC, and other relevant coding guidelines. • Validate and ensure the completeness, accuracy, and integrity of coded data. • Identify and resolve coding discrepancies or discrepancies between clinical documentation and diagnosis coding. • Stay up-to-date with the latest coding guidelines, rules, and regulations related to Risk Adjustment and HCC coding. • Adhere to all compliance and HIPAA regulations to maintain data security and patient confidentiality. • Collaborate with healthcare providers, physicians, and other team members to clarify documentation and resolve coding queries. • Participate in coding education and training programs to enhance coding skills and knowledge. • Prepare and submit reports related to coding activities, coding accuracy, and any coding-related issues or trends. • Assist in internal and external coding audits to ensure the quality and compliance of coding practices. • Identify opportunities for process improvement and efficiency in the coding process. • Offer suggestions to enhance coding documentation and accuracy.