What are the responsibilities and job description for the Billing & Coding Reconciliation Specialist position at Epiphany Family Services, LLC?
Location: Charlotte - Hybrid
Department: Revenue Cycle / Finance
Employment Type: Full-Time
Position Overview
We are seeking a detail-oriented and analytical Billing & Coding Reconciliation Specialist to join our team. This role is responsible for ensuring accuracy in medical billing and coding processes, reconciling accounts, resolving discrepancies, and optimizing revenue cycle performance. The ideal candidate will have strong knowledge of coding standards, insurance guidelines, and billing systems, with a proactive approach to identifying and resolving issues.
Key Responsibilities
- Review, reconcile, and validate billing and coding data to ensure accuracy and compliance
- Investigate and resolve claim discrepancies, denials, and payment variances
- Submit, track, and follow up on insurance claims for timely reimbursement
- Analyze Explanation of Benefits (EOBs) and remittance advice to identify issues
- Ensure proper use of coding systems (ICD-10-CM, CPT, HCPCS)
- Maintain compliance with federal, state, and payer-specific regulations
- Collaborate with clinical, administrative, and finance teams to resolve billing issues
- Monitor accounts receivable and assist in reducing outstanding balances
- Identify trends in denials or coding errors and recommend process improvements
- Maintain accurate documentation and audit trails for all reconciliation activities
Minimum Qualifications
Education:
- High School Diploma or GED (required)
- Associate Degree in Health Information Management, Medical Billing & Coding, or related field (preferred)
Certifications (preferred/strongly encouraged):
- CPC (Certified Professional Coder)
- CCS (Certified Coding Specialist)
- CBCS (Certified Billing & Coding Specialist)
Experience
- 1–3 years of experience in medical billing and/or coding
- Experience with insurance claims processing, denials management, and reimbursements
- Familiarity with Electronic Health Records (EHR) systems
Technical Skills
- Proficiency in coding systems:
- ICD-10-CM
- CPT
- HCPCS
- Experience with CMS-1500 (professional claim form)
- Strong understanding of insurance guidelines (Medicare, Medicaid, and commercial payers)
- Proficiency in billing software and Microsoft Office Suite (especially Excel)
Additional Qualifications
- Strong attention to detail and high level of accuracy
- Excellent analytical and problem-solving skills
- Ability to manage multiple tasks and meet deadlines in a fast-paced environment
- Strong communication skills (written and verbal)
- Knowledge of HIPAA compliance and healthcare privacy standards
- Experience with audits, compliance reviews, or revenue cycle management (preferred)
- Ability to work independently and collaboratively within a team
Benefits
We offer a competitive and comprehensive benefits package, including:
- Medical Insurance
- Dental Insurance
- Vision Insurance
- Group Life Insurance
- Paid Time Off (PTO)
- Paid Holidays
Why Join Us
- Competitive salary and benefits package
- Opportunities for professional growth and certification support
- Collaborative and mission-driven work environment
- Commitment to quality care and operational excellence
Equal Employment Opportunity (EEO) Statement
We are an Equal Opportunity Employer and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, gender, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other protected characteristic in accordance with applicable federal, state, and local laws.