Revenue Cycle and Coding Specialist

We are seeking a detail-oriented Revenue Cycle and Coding Specialist to support accurate, complete, and compliant clinical documentation, coding, billing, reimbursement, and revenue cycle processes. The ideal candidate will have experience in clinical documentation improvement, clinical coding, billing, health information management, and revenue cycle operations.

Remote position with occasional travel to the office may be required. Experience in FQHC and behavioral health settings is preferred.

Qualifications

include active coding certificate, associates degree in related education or experience in health information management, medical coding, billing, or a clinical profession; a recognized coding, clinical, or health information credential; strong knowledge of ICD-10-CM/PCS, CPT, HCPCS, payer guidelines, reimbursement, medical necessity, medical terminology, anatomy, physiology, clinical documentation, records management, billing terminology, and healthcare compliance.

The role also requires the ability to analyze and present complex information clearly, proficiency with Microsoft Office, Excel, Teams, internet resources, EHR and practice management systems, encoders, clearinghouses, and billing software, along with professional, service-oriented communication and strong attention to detail.

Responsibilities Include

Analyze clinical documentation to identify opportunities for improvement. Provide or coordinate education Partner with departments, clinical and revenue cycle teams Participate and complete audits Analyze and react to data Maintain and possess working knowledge of multiple payer types Ability to maintain confidentiality of patient information and comply with HIPAA and organizational privacy policies.

Review and ensure accurate data is documented Assign appropriate ICD-10-CM, CPT, HCPCS, and modifiers, based on documentation and applicable coding guidelines. Prepare, review, submit, and track clean claims for all payer plans Prepare, review, submit, and track prior authorizations Process reimbursements and payments Monitor accounts receivable Perform other job-related duties as assigned.