What are the responsibilities and job description for the Medical Billing and Coding Specialist position at ORTELE HEALTH?
Medical Biller / Coder & Credentialing Specialist
About Us
Michigan-based telemedicine practice delivering accessible, high quality care to patients across the state and currently expanding our revenue cycle and compliance team to support our growing network of healthcare partners and providers.
Position Summary
The Medical Biller / Coder & Credentialing Compliance Specialist plays a pivotal role in ensuring the practice maintains the highest standards of accuracy, integrity, and efficiency in all aspects of billing, coding, and credentialing. This position requires a strong understanding of healthcare compliance, medical coding, and revenue cycle operations, with an analytical mindset to identify workflow improvements and recommend strategies for financial optimization.
The ideal candidate will bring a proactive approach to compliance monitoring, audit readiness, and documentation review; providing actionable insight to leadership on improving practice performance, program profitability, and adherence to payer guidelines.
Key Responsibilities
Compliance, Auditing & Documentation
- Conduct routine chart and order audits for accuracy, coding integrity, and regulatory compliance.
- Review provider documentation to ensure adherence to E/M, HCC, and HEDIS quality measure requirements.
- Identify potential compliance risks or audit findings and provide recommendations for corrective action.
- Develop and maintain policies to support compliant billing and coding workflows across telemedicine service lines.
Credentialing & Enrollment
- Complete and maintain provider enrollments, payer credentialing, and contract renewals with commercial, Medicaid, and Medicare carriers.
- Manage CAQH, NPPES, and PECOS updates for active providers.
- Ensure timely onboarding and maintenance of provider participation across multiple payer networks.
Billing & Coding
- Assign and validate CPT, ICD-10, and HCPCS codes to ensure accurate and compliant claim submission.
- Support claim review, submission, payment posting, and denial management as needed.
- Collaborate with operations and clinical teams to ensure coding accuracy aligns with provider documentation.
Revenue Cycle Optimization
- Analyze claim patterns, denial trends, and reimbursement reports to identify process improvement opportunities.
- Recommend updates to billing practices, service line offerings, and care delivery models to improve profitability.
- Support the implementation of new service programs or payer initiatives aligned with company’s strategic goals.
Required Qualifications
- Education: High school diploma or equivalent required; associate’s or bachelor’s degree preferred.
- Experience: Minimum 2-3 years of medical billing, coding, and credentialing experience required; telemedicine or multi-specialty experience preferred.
- Certification: CPC, CCA, CBCS, or equivalent strongly preferred.
- Advanced knowledge of ICD-10, CPT, and HCPCS coding standards.
- Working understanding of HCC/Risk Adjustment, E/M guidelines, and federal compliance regulations.
- Experience with Medicare, Medicaid, and commercial insurance credentialing processes.
- Strong proficiency in Microsoft Excel, Word, and electronic health record (EHR) systems.
- Proven ability to work independently, maintain confidentiality, and exercise sound judgment.
Preferred Skills
- Experience conducting internal audits and compliance reviews.
- Familiarity with Michigan Medicaid and Medicare Part B telehealth billing.
- Strong analytical and problem-solving skills with an ability to translate findings into actionable improvements.
- Excellent written communication and attention to detail.
- Interest in contributing to organizational growth and service expansion, including recommendations for new programs or service lines.
Why Choose Us
- Mission driven organization transforming access to care in Michigan.
- Collaborative, flexible, and remote work environment.
- Opportunity to contribute to telemedicine innovation and excellence.
- Competitive compensation and professional growth potential.
Work Location & Requirements
This is a remote position for candidates based in Michigan and within driving distance of company headquarters in Wixom, MI.
Occasional in person meetings at the office may be required.
How to Apply
Submit your resume and a brief cover letter highlighting your experience with billing compliance, credentialing, and audit processes to:
Subject Line: Medical Billing/Coding Specialist
Job Types: Full-time, Part-time
Pay: From $22.00 per hour
Work Location: Remote
Salary : $22