What are the responsibilities and job description for the Billing and Coding Specialist (Contract) - Remote position at mainstreethealth?
About Us:
Main Street Health is the nation's largest provider of value-based care exclusively serving rural America. We believe in the old ways of medicine when healthcare was simpler. By partnering with rural primary care doctors, we reinforce the importance of trust and relationship-driven care in rural communities. We provide our partners with the staff, technology, and processes necessary to succeed in a value-based delivery model.
About the Role
We are seeking a detail-oriented, Certified Professional Coder (CPC) to join our Billing team as a Medical Coder. This role will be responsible for ensuring complete, accurate, and compliant coding for medical encounters across multiple states, payers, and electronic medical record (EMR) systems. The ideal candidate brings experience with Medicare Advantage and risk adjustment (HCC) coding, along with a proven ability to work in dynamic, multi-EMR environments. This role requires a strong understanding of medical terminology and healthcare regulations.
This is a remote contract position (1099) with the opportunity to convert to a full-time role within 6–12 months based on performance and business needs.
Responsibilities
- Review clinical documentation and assign accurate ICD-10-CM, HCPCS, and CPT codes to encounters
- Ensure compliance with CMS, payer, and risk adjustment coding guidelines
- Perform coding audits and validations for completeness and accuracy
- Collaborate with clinicians and billing staff to clarify documentation or coding discrepancies
- Support clean claim submission and reduce denials through proactive review and communication
- Stay current with changes in payer policies, coding updates, and HCC/risk adjustment models
- Maintain productivity and quality standards as defined by the Billing team
Qualifications
- Required: Certified Professional Coder (CPC) credential through AAPC
- Required: Demonstrated experience with risk adjustment (HCC) and Medicare Advantage coding
- Required: Experience working with multiple EMR systems (Athenahealth, eClinicalWorks, Epic, Cerner, etc.)
- Strongly Preferred: Experience with multi-payer and multi-state billing environments
- Preferred: Certified Risk Adjustment Coder (CRC) credential through AAPC
- Minimum of 2 years of medical coding experience (3 years preferred)
- Thorough understanding of CMS, ICD-10-CM, CPT, and HCPCS Level II coding guidelines
- Strong attention to detail, analytical skills, and ability to work independently in a remote setting
- Excellent communication and collaboration skills
- Ability to work independently and manage multiple tasks
Those who thrive at Main Street Health possess these qualities:
- An entrepreneurial spirit. Must be a tenacious self-starter.
- Flexible and adaptable to a constantly changing workload.
- Must enjoy working in a fast-paced environment.
- A sense of humor and a down-to-earth nature.
Employment Type: 1099