Certified Coding and Billing Compliance Specialist

Snowline Health•El Dorado, CA

2d•Hybrid

About The Position

The Certified Coder and Billing Compliance Specialist is responsible for reviewing and coding medical records to ensure accurate, compliant billing in accordance with Medicare, Medicaid, and private insurance requirements. This role evaluates clinical documentation, assigns ICD-10, CPT, HCPCS, E/M, CCM, and TCM codes, identifies missed or incorrect charges, and resolves coding and claim discrepancies prior to submission. The position works closely with providers and the billing team to support documentation integrity, denial prevention and resolution, audit readiness, and regulatory compliance, while providing education and reporting to strengthen revenue integrity. Through these efforts, the role helps ensure timely reimbursement and supports the financial sustainability of Snowline Health’s mission-driven care programs.

Requirements

Certified Professional Coder (CPC) from AAPC, or Certified Coding Specialist – Physician based (CCS-P) from AHIMA, with proficiency in medical coding systems (CPT, ICD-10, HCPCS).
Minimum 2 years of experience in medical records coding and clinic/multi-specialty billing compliance.
Familiarity with Electronic Medical Record (EMR) systems and billing platforms.
Excellent written and verbal communication skills for effective collaboration with providers, billing staff, and management.
Knowledge and practical understanding of CMS regulations and conditions of participation and OIG audit trends, as they relate to Hospice, Palliative Care and In Home Based Primary Care reimbursement models.
Deep understanding of medical terminology, anatomy, physiology, and pharmacology.
Excellent attention to detail, analytical and organizational skills.
Ethical judgment, exercising discretion and maintaining patient confidentiality in accordance with HIPAA.
Ability to work independently and as part of a team.

Nice To Haves

CPMA, and CPB certifications.

Responsibilities

Reviewing and coding medical records to ensure accurate, compliant billing in accordance with Medicare, Medicaid, and private insurance requirements.
Evaluating clinical documentation, assigning ICD-10, CPT, HCPCS, E/M, CCM, and TCM codes.
Identifying missed or incorrect charges.
Resolving coding and claim discrepancies prior to submission.
Working closely with providers and the billing team to support documentation integrity, denial prevention and resolution, audit readiness, and regulatory compliance.
Providing education and reporting to strengthen revenue integrity.
Ensuring timely reimbursement and supporting the financial sustainability of Snowline Health’s mission-driven care programs.