Coding & Billing Specialist

📋 Description

• Submit accurate, timely, and compliant claims using appropriate CPT, HCPCS, ICD-10 codes
• Track and resolve claim denials, rejections, and underpayments through investigation, follow-up
• Validate patient eligibility, authorizations, and appropriate billing pathways for individual
• Ensure accurate application of telehealth, social determinants of health, preventive care, and
• Coordinate with credentialing teams, partner operations, and payer representatives to resolve
• Review provider documentation and assign accurate codes in accordance with ICD-10-CM, CPT, HEDIS

🎯 Requirements

• AAPC Certified Professional Coder (CPC) certification is required, with credentials subject to
• 3–5 years of professional experience in physician medical billing and coding; pediatric experience
• Strong working knowledge of CPT, HCPCS, ICD-10, HEDIS, Medicaid, and commercial payer requirements.
• Proficiency with Athenahealth or similar electronic medical record systems and Microsoft Excel.
• Demonstrated understanding of medical claims workflows, coding compliance, eligibility
• Strong attention to detail and the ability to identify coding, documentation, and billing

🎁 Benefits

• Annual salary range of $55,000–$65,000 USD, with compensation determined based on job-related
• Annual bonus incentive opportunity.
• Competitive medical, dental, and vision insurance.
• Healthcare and Dependent Care Flexible Spending Accounts.
• Company-funded Health Savings Account.
• 401(k) plan with a 4% employer match, fully vested from day one.