Coding Specialist Biller 2 (WA)_Revenue Cycle Operations

PPGNHAIK

5d•$27 - $39•Onsite

About The Position

Under the supervision and direction of the Director, Manager, or Supervisor, the Coding Specialist/Biller 2 ensures compliance in medical documentation, coding, and billing. The role performs Biller 2 duties while setting aside time for coding and documentation activities. The position supports coding and revenue cycle activities and works with staff to improve front-end revenue cycle procedures in health centers. The role ensures coding and billing comply with applicable rules and regulations; reviews coding and claims; manages work queues, denials, rejections, and documentation queries; and supports timely, accurate claim submission and reimbursement. It also responds to patients, health center staff, and insurers, provides pre-verification services as requested, supports audits, and supplies medical records for billing-related requests. The position is full-time and non-exempt, located at 2001 East Madison Street, Seattle, Washington. The listed pay range is $26.65–$38.93 per hour. Employees must present proof of a current flu shot before their first day and are expected to follow organizational policies, maintain professionalism, model customer service standards, and pursue ongoing learning and development.

Requirements

Certified Professional Coder (CPC) certification required.
At least two years of experience in a medical billing operation.
Demonstrated experience with electronic practice management and health record systems.
Thorough understanding of third-party payer contracts, Medicaid reimbursement, and compliance.
Proficiency and advanced working knowledge of CPT-4 and ICD-10 coding requirements.
Advanced knowledge of third-party billing and OIG billing compliance guidelines.
Ability to maintain confidentiality of all PPGNHAIK business and activities, on and off the job.
Proof of a current flu shot must be presented before the first day of employment.

Nice To Haves

Associate degree in finance, accounting, or a related field preferred.
Epic experience is a plus.
Experience with health center management is highly desirable.
Comprehensive, in-depth experience with the front-end revenue cycle.

Responsibilities

Perform prospective and retrospective coding reviews to ensure claim accuracy and make corrections needed for payer reconsideration.
Submit and manage provider coding queries when additional documentation or a provider response is needed.
Work assigned queues to verify claim accuracy, take corrective action, and ensure timely filing.
Write off balances when appropriate, within the approval level authorized for a Coding Specialist/Biller.
Review rejections and denials, including coding and documentation issues, and take action to resolve claims.
Identify trends in rejections and denials and report findings to the Coding Integrity Manager for follow-up.
Ensure quality, compliance, and continuous improvement in coding, documentation, and billing.
Bill third-party payers accurately to maximize reimbursement while following department procedures and processes.
Check proof of eligibility according to organizational and third-party protocols.
Respond to inquiries from patients, health center staff, and insurance companies according to affiliate customer service standards.
Provide pre-verification services to health centers and patients as requested.
Monitor help desk tickets, refer patient callback tickets to a Patient Account Representative when appropriate, and resolve other tickets promptly.
Manage work queues and correct electronic bill submissions to ensure bills are processed on time.
Follow up on incorrect, denied, and unpaid claims, and reconcile third-party accounting information.
Support internal and external coding audits.
Provide medical records for billing-related requests, including claim reimbursement, payer audit, and risk adjustment requests.
Work with staff to improve front-end revenue cycle procedures in health centers.
Adhere to the organization’s code of conduct, policies, procedures, and protocols; demonstrate professionalism, model customer service standards, and seek ongoing training and development.