Medical Coder

We are seeking a detail-oriented and experienced Medical Coder & Billing Coordinator to oversee and manage all aspects of medical coding and billing for our clinic and affiliated nursing home services. This role ensures accurate coding, compliance with payer guidelines, and timely billing to maximize revenue and minimize claim denials.

Key Responsibilities:

Review clinical documentation and assign accurate CPT, ICD-10, and HCPCS codes for clinic and nursing home encounters.

Submit claims electronically and track billing for all services rendered in both settings.

Monitor and follow up on unpaid claims, rejections, and denials; initiate appeals as needed.

Ensure billing practices are compliant with Medicare, Medicaid, and private payer policies.

Perform routine audits of documentation and billing to ensure accuracy and compliance.

Coordinate with clinical and administrative staff to resolve documentation or coding issues.

Prepare and distribute monthly billing reports to leadership, highlighting revenue trends and outstanding AR.

Stay up to date with changes in coding regulations, payer rules, and compliance requirements.

Support credentialing and payer enrollment tasks as needed.

Requirements:

Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification required

3+ years of experience in medical coding, preferably with exposure to both outpatient and long-term care environments

Strong knowledge of ICD-10, CPT, HCPCS, and medical terminology

Familiarity with EHR and billing systems (e.g., Epic, Cerner, or similar)

Excellent analytical, communication, and problem-solving skills

Ability to manage multiple tasks and maintain high accuracy under pressure

Knowledge of payer-specific guidelines and state/federal billing regulations