Medical Coding/Billing Specialist

The Medical Billing & Coding Specialist is responsible for accurately reviewing, coding, billing, and submitting medical claims while ensuring compliance with federal regulations, payer requirements, and company policies. This position plays a vital role in optimizing reimbursement, maintaining coding integrity, and supporting the overall revenue cycle through accurate documentation review, claims processing, and payer follow-up.

Essential Duties and Responsibilities

• Review patient encounters and provider documentation to ensure accuracy, completeness, and compliance with coding and billing requirements.
• Assign and validate appropriate ICD-10-CM, CPT®, HCPCS Level II codes, and applicable modifiers in accordance with current coding guidelines.
• Generate, review, and scrub claims for accuracy prior to submission to minimize denials and maximize reimbursement.
• Submit electronic claims through designated clearinghouses and paper claims as required by payer guidelines.
• Monitor provider documentation for coding compliance and communicate with providers to obtain clarification or documentation corrections when necessary.
• Maintain compliance with all Health Insurance Portability and Accountability Act (HIPAA) privacy and security regulations.
• Remain current on coding updates, payer policies, National Correct Coding Initiative (NCCI) edits, Medicare regulations, and reimbursement requirements.
• Identify billing trends, reimbursement issues, coding discrepancies, and denial patterns, and report findings to the Director of Revenue Cycle.
• Review insurance policies, payer guidelines, and reimbursement methodologies to ensure claims are billed appropriately.
• Assist with Merit-Based Incentive Payment System (MIPS), quality reporting, and other value-based reimbursement initiatives as assigned.
• Work denied, rejected, or returned claims and coordinate timely claim corrections and resubmissions.
• Collaborate with providers, clinical staff, and revenue cycle personnel to improve documentation quality and billing accuracy.
• Maintain productivity and quality standards established by the department.
• Participate in internal audits, compliance initiatives, and coding education as requested.
• Maintain confidentiality of patient, provider, and organizational information.
• Perform additional duties and special projects as assigned by the Director of Revenue Cycle or Chief Operating Officer.

Required Qualifications

• High school diploma or equivalent required.
• Medical Billing and/or Coding certification preferred (CPC, CCS-P, CCA, RHIT, RHIA, or equivalent).
• Minimum of two (2) years of medical billing and coding experience preferred.
• Strong working knowledge of ICD-10-CM, CPT, HCPCS, modifiers, payer guidelines, and reimbursement methodologies.
• Experience with electronic health records (EHR), practice management software, and clearinghouses.
• Knowledge of Medicare, Medicaid, commercial insurance, and value-based reimbursement programs.
• Strong analytical, organizational, and problem-solving skills.
• Excellent written and verbal communication skills.
• Ability to manage multiple priorities while maintaining a high level of accuracy and attention to detail.

Job Type: Full-time

Pay: $20.00 - $27.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

People with a criminal record are encouraged to apply

Ability to Commute:

• Wichita, KS 67203 (Required)

Work Location: In person

Salary : $20 - $27