Coding and Billing Specialist

Responsibilities

• Reviews provider documentation and claims to ensure coding accuracy, billing compliance, and adherence to regulatory requirements.
• Audits medical coding, performs billing functions, and manages third-party billing follow-up.
• Ensures claims submitted to Medicare, Medicaid, Railroad Retirement, Medicare Advantage, and commercial payers are accurate and compliant with payer and state-specific guidelines.
• Investigate and resolve payer correspondence, denials, and payment discrepancies by initiating appeals, submitting corrected claims, providing supporting documentation, and responding to payer requests.
• Process cash postings, adjustments, refunds, overpayments, and credit balances in accordance with organizational policies and payer requirements.
• Maintain current knowledge of Medicare, Medicaid, commercial payer, and regulatory billing guidelines; ensure compliance with insurance requirements, licensure regulations, and CMS response deadlines.
• Document account activity accurately and consistently to support accounts receivable management and provide visibility into actions taken and next steps.
• Collaborate effectively with Medical Center Operations, Coding, Compliance, and other stakeholders while maintaining confidentiality, adapting to change, and performing other duties as assigned.

Qualifications

• 1+ year’s experience in coding and medical billing experience preferred.
• Podiatry specialty preferred.
• Strong written, verbal, and interpersonal communication skills.
• Critical thinking and problem-solving abilities with strong attention to detail.
• Proficiency in Microsoft Office Suite.
• Working knowledge of electronic claims processing, denial resolution, reimbursement practices, and federal, state, and third-party payer requirements.
• Certified Coding Professional-Physician (CCS-P) or Certified Professional Coder (CPC) certification is preferred.

Benefits

• Compensation: $54,000 - $60,000 per year, plus eligibility for annual bonus.
• Medical, dental and vision packages, including an annual reimbursement for qualified wellness expenses, personal health coaching and telemedicine options.
• PTO Plans, PLUS company paid volunteer hours for eligible team members, in accordance with applicable state law.
• 401k for all team members 18 and over with a company 3% match.
• Free access to our on-site Team member Health and Well-Being Centers, plus Well-Being programs, tools and resources for you and your immediate family members.
• Growth Opportunities – grow with the company as we open new communities and expand on our existing ones!