Job Description
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.
Role Description
The Coding & Billing Specialist is a critical, full-time, salaried position within firsthand’s clinical documentation team. This role is a foundational hire, offering the opportunity to define key processes and program elements for comprehensive and accurate coding of clinical services.
- Key Responsibilities
- Coding & Auditing:
- Perform day-to-day encounter coding for services, procedures, diagnoses, and treatments.
- Verify that all assigned codes (ICD, CPT, and HCPC) are compatible, appropriate, and accurate for billing.
- Audit clinical notes for supporting documentation and code to the highest specificity.
- Use medical terminology to confirm clinical documentation supports the reported diagnoses.
- Conduct coding corrections.
- Claims & Revenue Cycle Management:
- Prepare and submit claims for payment.
- Correct and resubmit rejected claims.
- Maintain Accounts Receivable (A/R) for revenue cycle management.
- Expertise & Process Improvement:
- Serve as the subject matter expert on firsthand's billing systems, including the Electronic Health Record (EHR) and Clearinghouses.
- Advise on and implement ongoing process improvements related to coding and billing.
- Develop and update procedures manuals to ensure correct coding standards and minimize fraud/abuse risk (e.g., revising the master CPT list).
- Education & Support:
- Educate firsthand Advanced Practice Nurses (APNs), Nurse Practitioners (NPs), and other team members on proper code selection, documentation, procedures, and requirements.
- Provide technical guidance to clinical staff in resolving coding issues, such as incomplete or ambiguous documentation.
- Qualifications
- 4+ years of experience as a medical billing and coding specialist, leveraging an EHR system.
- A High School diploma or equivalent.
- Required Medical Coder Certification:
- Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist (CCS) from AHIMA.
- Nice-to-have:
- Certified Risk Adjustment Coder (CRC) from AAPC.
- Requirements
- Strong knowledge of ICD-10-CM and CPT coding guidelines.
- Proficiency in medical terminology, with the ability to read and interpret medical procedures and documentation.
- Expertise in state and federal Medicare reimbursement guidelines.
- Ability to quickly gain proficiency in firsthand’s specific EHR, Clearinghouse, and other billing software.
- Strong multi-tasking skills and consistent attention to detail.
- Excellent written and verbal communication skills for maintaining collaborative relationships with APNs, NPs, the Clinical Documentation Integrity Specialist, and other team members.
- Support firsthand’s mission, vision, and values by demonstrating respect, dignity, empathy, and professional conduct.
- Benefits
- Base salary range: $55,000 - $55,000 USD.
- Compensation package includes base, equity (or a special incentive program for clinical roles), and performance bonus potential.
- Benefits include physical and mental health, dental, vision, 401(k) with a match.
- 16 weeks parental leave for either parent.
- 15 days/year vacation in your first year (this increases to 20 days/year in your second year and beyond).
- A supportive and inclusive culture.
Apply tot his job
Apply To this Job