Rural Health Clinic Coder
Elderberry Healthā¢Ashland City, TN
About The Position
The Medical Billing & Coding Specialist will review completed encounters and claims prior to submission to identify coding, billing, demographic, payer, and claim-form errors. The goal of this position is to make sure claims are clean and accurate before they are submitted, reducing denials, rework, and payment delays. The position is expected to require approximately 1ā2 hours per day, with flexibility in scheduling based on clinic volume.
Requirements
- Knowledge of CPT, HCPCS, ICD-10-CM, and medical billing guidelines
- Familiarity with electronic claim submission and clearinghouses
- Strong attention to detail
- Ability to identify billing errors and independently research solutions
- Ability to work independently with minimal supervision
- Strong organizational and communication skills
Nice To Haves
- 2+ years of medical billing and/or coding experience
- Experience with Rural Health Clinics (RHCs) strongly preferred
- Experience with Medicare RHC billing preferred
- Experience with TennCare/Medicaid and Medicare Advantage billing preferred
- Experience with eClinicalWorks preferred
Responsibilities
- Review completed encounters and claims for accuracy before submission
- Verify that appropriate CPT, HCPCS, ICD-10-CM, and applicable modifiers are used
- Review claims for common billing errors and missing information
- Ensure claims are submitted using the appropriate billing methodology for Rural Health Clinic (RHC) services
- Review payer-specific requirements and identify potential claim issues before submission
- Assist with proper billing of Medicare, TennCare/Medicaid, Medicare Advantage, commercial insurance, and other payers
- Identify claims that may require correction prior to submission
- Review claim edits, rejections, and clearinghouse errors
- Assist with correcting and resubmitting rejected claims when needed
- Monitor recurring denial and rejection trends and communicate issues to clinic leadership
- Work within eClinicalWorks (eCW) and applicable clearinghouse/payer portals
- Maintain awareness of payer billing and coding requirements
- Assist with periodic review of accounts receivable and outstanding claim issues as needed
- Communicate with clinic staff regarding documentation or coding issues that could affect reimbursement
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What This Job Offers
Job Type
Part-time
Career Level
Entry Level
Education Level
No Education Listed
