Biller Coder

Lynn County Hospital District•Tahoka, TX

60d•Onsite

About The Position

The Medical Biller & Coder is responsible for accurate and compliant coding, charge review, claim preparation, and follow-up to ensure timely reimbursement for hospital and clinic services. This position also plays a critical role in identifying trends, documentation gaps, coding issues, and new regulatory or payer updates—and communicating these findings through staff education. This position works under the direct supervision of the Business Office & Billing Operations Manager, who provides oversight, training, and direction for all billing, coding, registration cross-training, and revenue cycle improvement efforts. Because rural hospitals require team members who can flex across departments, this role is also cross-trained in patient registration and may assist with front desk duties as needed to support patient flow and operational coverage.

Requirements

High school diploma or equivalent required.
Strong knowledge of ICD-10, CPT, HCPCS, modifiers, medical terminology.
Familiarity with Medicare, Medicaid, commercial payer rules, CAH/RHC billing.
Ability to interpret regulatory updates and apply them appropriately.
Excellent communication skills for staff and provider education.
Strong attention to detail and organizational abilities.
Ability to multitask and flex across different departments.
Professional, positive, patient-centered attitude.
Prolonged sitting, standing, computer-based work.
Ability to move between departments or clinic locations.
Must maintain confidentiality and comply with HIPAA and all hospital policies.

Nice To Haves

Coding certification preferred (CPC, CCA, CCS, etc.).
Prior experience in medical billing/coding strongly preferred.
Registration/front desk experience preferred.
Rural healthcare experience is highly beneficial.

Responsibilities

Assign accurate ICD-10, CPT, HCPCS, and modifier codes based on clinical documentation for hospital, RHC, PT/OT, ER, ambulance, and specialty services.
Review claims for completeness, compliance, and proper charge capture prior to submission.
Verify medical necessity and ensure documentation supports billed services.
Monitor queues and clearinghouse rejections and payer denials; correct and resubmit timely.
Post insurance payments, adjustments, and denials as needed.
Track coding updates, regulatory changes, payer policy revisions, and CMS guidelines.
Perform internal audits of clinical documentation to ensure accuracy and compliance.
Follow all processes, workflows, and directives established by the Business Office & Billing Operations Manager.
Identify recurring errors in registration, documentation, coding, or billing.
Recognize patterns that impact reimbursement, compliance, or patient satisfaction.
Report trends to the Business Office & Billing Operations Manager for review and corrective action planning.
Maintain logs that support internal audits, education tracking, and improvement efforts.
Provide education—under the direction and approval of the Business Office & Billing Operations Manager—to clinical and clinical support staff regarding documentation requirements, coding issues, and guideline changes.
Help providers and staff understand coding requirements, Medicare/RHC/CAH-specific rules, and proper use of modifiers.
Develop easy-to-follow education materials, tip sheets, and workflows when assigned.
Participate in staff meetings, huddles, or in-service training at the manager’s request.
Maintain competency in clinic and hospital registration workflows.
Verify insurance eligibility, obtain demographics, and collect copays when needed.
Assist with insurance updates, coverage verification, and accurate account creation.
Support Registration staff during high-volume periods, vacations, call-ins, or shortages.
Promote accurate front-end processes to ensure clean claims and reduce rework.
Help in other revenue cycle or operational areas as directed by the Business Office & Billing Operations Manager.
Provide back-up support for AR, medical records, credentialing/enrollment, payment posting, or patient navigation when needed.
Maintain knowledge of CAH Method 2 billing, RHC AIR rules, Medicare Advantage, Medicaid MCO policies, and commercial payer requirements.
Demonstrate teamwork, professionalism, and adaptability in a dynamic rural healthcare environment.