Billing and Coding Specialist
Main Street Health
contract
Posted on:
Location Type: Remote
Location: Tennessee • United States
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About the role
- 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
Requirements
- 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
Benefits
- Flexible work arrangements
- Opportunity to convert to a full-time role
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
ICD-10-CM codingHCPCS codingCPT codingrisk adjustment codingcoding auditscoding validationsmedical codingmulti-payer billingmulti-state billingEMR systems
Soft Skills
attention to detailanalytical skillscommunication skillscollaboration skillsindependent worktask management
Certifications
Certified Professional Coder (CPC)Certified Risk Adjustment Coder (CRC)