• 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

Role 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. Responsibilities - Serve as a 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. - Identify problem areas and trends encountered while working with any team or department and communicate findings to management. - Remain proficient in the use of specific applications related to the coding team’s function, i.e. billing systems, EMRs, internal portals, team communication tools, etc. - Other duties as assigned. Qualifications - Required: CPC or CPC-A (AAPC). Additional certifications (e.g., CRC, CPC-H) is a plus. - High school diploma or equivalent required. Requirements - 2–3+ years of professional coding experience, preferably in Revenue Cycle Management. - Experience with coding audits or quality assurance processes. - Experience across multiple specialties. - Experience with Candid Health billing software a plus. - Proficient in CPT, ICD-10, and HCPCS coding systems. - Strong knowledge of medical terminology, anatomy, and physiology. - Intermediate knowledge of revenue cycle processes and best practices. Skills & Attributes - Strong organizational skills, time management, and attention to detail. - Self-motivated and able to work autonomously, multitask, and shift priorities quickly. - Sound judgment and reliable follow-through on deadlines. - Excellent written and verbal communication skills.

• Independently prepare and review private medical invoices according to the German Medical Fee Schedule (GOÄ) • Handle correspondence • Support invoice dispatch and perform administrative tasks • Temporary holiday cover (fully remote work possible)

• Review clinical documentation and assign accurate CPT, HCPCS, ICD-10, and E/M codes • Ensure coding complies with national coding guidelines, payer requirements, and Hope Network policies • Query providers to clarify documentation and support accurate code selection • Review and resolve coding-related claim edits, denials, and payer rejections • Collaborate with providers, billing teams, and leadership to improve coding accuracy and reimbursement • Analyze coding trends and prepare reports to support operational improvements • Provide coding education and guidance to providers and staff • Assist with special projects and revenue cycle initiatives while supporting efficient billing operations