Medical Billing and Coding Specialist

Lower Rio Grande Valley Community Health Management Corporation, Inc.
EL MILAGRO CLINIC
Job Title: Billing and Coding Specialist

IN PERSON

El Milagro Clinic is seeking a detail-oriented, experienced Billing and Coding Specialist to support our team in ensuring accurate and timely billing and reimbursement processes. The ideal candidate will be knowledgeable in medical billing procedures, coding systems, and insurance guidelines (Medicare, Medicaid, commercial payers), and will work closely with clinical and administrative staff to maintain compliance and financial integrity.

Key Responsibilities:

• Accurately input and submit medical claims using appropriate CPT, ICD-10, and HCPCS coding systems.
• Review and audit patient charts to ensure proper coding and documentation for billing compliance.
• Verify insurance eligibility and benefits prior to patient appointments.
• Process insurance claims and patient billing through the clinic’s Electronic Medical Records (EMR) system.
• Correct and resubmit denied or rejected claims, and follow up with payers to ensure prompt reimbursement.
• Reconcile accounts receivable by tracking payments and outstanding balances.
• Maintain up-to-date knowledge of insurance guidelines, including Medicare, Medicaid, and commercial payers.
• Assist with credentialing and re-credentialing applications for healthcare providers.
• Collaborate with front desk and clinical staff to ensure complete and accurate patient information.
• Generate patient statements, process payments, and communicate with patients about balances or billing issues.
• Maintain confidentiality and ensure compliance with HIPAA and federal/state regulations.
• Support reporting efforts such as bad debt, collections, and cost reporting related to Medicare/Medicaid.
• Go over patient bills to ensure their accuracy; if any information is missing, obtain it.
• Verify claims got paid, if not fix and resubmit for payment.
• Regularly updates Medicare and Medicaid cost and bad-debt reports, billing, collection, and other related information.
• Follow all work processes, procedures, while maintaining compliance with the rules and regulations set forth by the organization.
• Strive to deliver high-quality results at all times in accordance with standards.
• Protect and keep all patient information confidential.
• Proudly service the organization by following all HIPAA, JCAHO, state, and federal laws and standards.
• Accept ownership for all tasks and responsibilities while improving the organization’s reputation.
• Actively explores new activities, networking opportunities, and educational pursuits to improve job knowledge and skills.

Qualifications:

• High School Diploma or GED required; Associate’s degree or certification in Medical Billing & Coding preferred.
• Minimum 2 years of experience in a medical billing or healthcare office environment.
• Strong knowledge of medical terminology and insurance billing guidelines (Medicare, Medicaid, PPO, HMO).
• Proficiency with EMR systems and medical billing software.
• Excellent organizational skills and attention to detail.
• Strong communication and problem-solving skills.
• Ability to work independently and as part of a team in a fast-paced clinical setting.
• Above-average critical thinking, communication, and analytical skills
• Ability to use computer systems and software (Word, Excel, PowerPoint. Etc)
• Bilingual (English/Spanish) required.

Job Type: Full-time

Pay: $11.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $11