Billing and Coding Assistant

Responsibilities

• Independently review and interpret clinical documentation to ensure accurate, compliant, and complete charge capture across pain medicine and related specialties
• Apply advanced knowledge of ICD-10, CPT, and modifier usage, including evaluation and management, procedural, and behavioral health coding
• Analyze and interpret government and commercial payer policies; determine appropriate coding approaches in complex or ambiguous scenarios
• Identify coding trends, discrepancies, and potential compliance risks; take appropriate action to resolve issues and mitigate risk
• Serve as a subject matter expert for providers and staff, providing guidance on documentation requirements, coding standards, and regulatory changes
• Collaborate directly with physicians, advanced practice providers, and clinical staff to resolve complex documentation issues and improve coding accuracy
• Exercise independent judgment in determining when documentation supports billing, when clarification is required, and when escalation is necessary
• Conduct ongoing review of charge sessions and coding work queues to ensure accuracy, timeliness, and compliance with departmental standards
• Monitor and analyze reports to identify patterns, gaps, and opportunities for process improvement and revenue optimization
• Support internal audits and compliance initiatives; assist in the development and implementation of corrective actions as needed
• Contribute to process improvement efforts, including recommending enhancements to workflows, systems, and coding practices
• Stay current on regulatory updates, coding changes, and industry best practices; apply this knowledge to departmental operations
• Perform additional duties and participate in special projects as assigned

Requirements

• Bachelor’s degree or equivalent in education and experience
• Minimum of four (4) years of professional coding experience in a healthcare setting, including complex specialty coding

Qualifications

• AAPC CPC, CANPC, or equivalent certification required (non-apprentice designation strongly preferred)
• Demonstrated expertise in professional services coding, including evaluation and management (inpatient and outpatient)
• Strong knowledge of anatomy, physiology, and medical terminology
• Experience interpreting payer policies and applying regulatory guidance in complex scenarios
• Epic or similar electronic health record experience preferred