Profee Coder/Biller

Pena4 Inc.; Remote; EUR 20.000 - 40.000; Teilzeit

Zusammenfassung

A healthcare consultancy company in Germany seeks a Profee Coder/Biller to handle coding and billing for Pediatrics, Mental Health, and Primary Care. Candidates must have at least 2 years of coding experience, preferably with CPC or CCS-P certification. Responsibilities include reviewing medical records for accurate coding and claims submission. This remote role offers a pay range of $23 - $25 per hour based on experience, requiring flexible scheduling to meet client needs.

Qualifikationen

• Proven experience in Obstetrics, Primary Care, Mental Health, and Pediatrics.
• Minimum of 2 years of relevant coding experience required.

Aufgaben

• Review clinical documentation and assign accurate ICD-10-CM, CPT, HCPCS codes.
• Prepare, submit, and monitor claims for various medical services.
• Collaborate with providers and clinical staff for coding accuracy.

Kenntnisse

Coding software knowledge (EPIC)

Microsoft Office Suite

ICD-10 official coding guidelines

Excellent oral and written communication skills

Ability to work independently

Strong organizational skills

Ability to multi-task

Ausbildung

High school diploma or higher in health information management

CPC or CCS-P certification

Jobbeschreibung

Assignment Details

• Profee coding and E/M levels and processing billing: OB, Primary Care, Mental Health, Pediatrics
• EPIC experience
• Position Type: 1099 Assignment
• $23 - $25 per hour (based on experience)
• Schedule: As needed based on client’s needs with flexible hours
• Length of assignment: Short term, possibly 3 – 4 months
• CPC or CCS-P required, billing certificates preferred I.

II. Position Summary The Profee Coder/Biller in this role must have demonstrated experience in Pediatrics, Obstetrics, Mental Health, and Primary Care, with a strong working knowledge of E/M coding and specialty-specific billing rules. This position is responsible for reviewing clinical documentation, assigning accurate ICD-10-CM, CPT, HCPCS, and E/M codes, and ensuring all claims are billed correctly and compliantly across these service lines. The Coder/Biller supports the full revenue cycle by preparing and submitting claims, resolving denials, validating documentation, and collaborating closely with providers and clinical staff to ensure coding accuracy and reimbursement integrity. The ideal candidate is detail-oriented, proficient in Epic and practice-specific billing platforms, and skilled in managing complex coding scenarios, including OB global packages, pediatric preventive services, behavioral health encounters, and chronic care management. This role is essential in promoting accurate documentation, compliant billing practices, and timely reimbursement, contributing directly to the organization’s operational and financial success.

Essential Job Requirements

Education – High school diploma, Associate or bachelor’s degree in health information management or similar preferred with required certifications. Acceptable coding or HIM certification, which include:

• CPC or CCS-P required
• Billing certifications

Experience

• Minimum of 2 or more years of relevant coding experience.
• High-level coding expertise in Physician Coding with experience in OB, Primary Care, Mental Health, and Obstetrics.

Required Skills

• Knowledge of Coding software, specifically EPIC
• Microsoft Office Suite experience
• Advanced knowledge of ICD-10 official coding guidelines, including the use of AHA Coding Clinic or similar authoritative resources.
• Excellent oral and written communication skills.
• Ability to work independently in a fast-paced environment.
• Ability to interact with management personnel and the provider community.
• Possess strong organizational skills and attention to detail.
• Ability to multi-task, meet multiple deadlines and prioritize workload.
• Adaptive and flexible to new ideas and change.

Roles and Responsibilities

Coding Responsibilities

• Review and analyze medical records across pediatric, obstetric, mental health, and primary care services to assign accurate ICD-10-CM, CPT, HCPCS, and applicable modifiers in accordance with national and payer‑specific guidelines.
• Code newborn care, well‑child visits, immunizations, acute pediatric encounters, OB global packages, deliveries, postpartum care, behavioral health visits, psychotherapy, psychiatric evaluations, telehealth encounters, preventive services, and chronic condition management.
• Ensure documentation supports all reported diagnoses and procedures; issue provider queries when clarification or additional detail is required.
• Apply correct global maternity rules, tracking antepartum, intrapartum, and postpartum components, as well as split‑billing scenarios when needed.
• Maintain a current understanding of specialty‑specific coding updates, including pediatric guidelines, OB global coding rules, behavioral health E/M and therapy codes, primary care preventive coding, NCCI edits, and payer policy updates.
• Collaborate with providers to ensure accurate documentation of mental health assessments, treatment plans, time‑based services, chronic care management, and risk condition capture.

Billing & Revenue Cycle Responsibilities

• Prepare, submit, and monitor claims for pediatric, OB, mental health, and primary care services with accuracy and efficiency.
• Review all claims for completeness, proper coding, required documentation, and compliance before submission.
• Identify, research, and resolve denials, rejections, and underpayments; determine root causes and initiate corrective action.
• Post payments, adjustments, and reconcile accounts to confirm accurate reimbursement across all service lines.
• Follow up on aged, unpaid, or variably paid claims, ensuring timely and appropriate payer responses.
• Ensure accurate billing for vaccines, immunizations, therapy sessions, integrated behavioral health services, chronic care management, telehealth services, and ancillary support services.
• Maintain a solid understanding of payer contracts and reimbursement methodologies specific to pediatrics, OB, mental health, and primary care.

Compliance & Quality

• Adhere to HIPAA, CMS, payer‑specific guidelines, and all federal and state regulations governing coding and billing.
• Participate in internal audits, address audit findings, and implement approved corrective actions.
• Meet established accuracy, productivity, and timeliness standards consistently.
• Identify gaps in documentation, coding trends, or workflow inefficiencies and recommend improvements to support revenue integrity and compliance.

Collaboration & Communication

• Partner with providers, clinical staff, mental health professionals, and administrative teams to clarify documentation, coding, and billing‑related issues.
• Serve as a resource for pediatric, OB, mental health, and primary care coding questions and guidance.
• Provide feedback and education to providers regarding opportunities to improve documentation and reduce denials.
• Communicate effectively and professionally across multidisciplinary teams.

Technology & Systems

• Utilize Epic and practice‑specific billing platforms for coding, charge entry, claim submission, payment posting, and account management.
• Maintain accurate and organized electronic records with full documentation and traceability of all billing and coding actions.

Additional Projects

• Assist with other projects as needed.

Pay

$23.00 - $25.00 per hour

Expected Hours

No less than 30.0 per week

Application Question(s)

• Do you hold EPIC Experience?
• Do you hold Profee Coder/Biller Experience?

License/Certification

• CPC or CCS‑P (Required)

Work Location

Remote