Medical Coding & Billing Specialist

About the role

Claims submission and coding accuracy share the same desk here, with denials and documentation gaps resolved alongside providers and the data team. The group is a startup, so priorities can shift and the role may grow into new markets or payer models.

At a glance

What you will do

• Submit clean claims with correct CPT, HCPCS, ICD-10 codes and modifiers
• Follow up on denials, rejections and underpayments and resubmit as needed
• Check eligibility, authorization and billing pathways for each encounter
• Review provider notes and assign codes under ICD-10-CM, CPT and HEDIS quality rules
• Keep the internal billing rules matrix current by payer, state, provider type and modifiers

What they look for

• AAPC Certified Professional Coder (CPC) certification
• Three to five years of physician billing and coding experience, pediatrics preferred
• Proficiency with Athena EMR and Microsoft Excel
• Solid grasp of CPT, HCPCS, ICD-10, HEDIS and Medicaid or commercial payers

Benefits

• Salary range of $55,000 to $65,000 plus an annual bonus incentive