Accounts Receivable Coding Specialist FT

Starcare Inc.; Lubbock (TX); Hybrid; USD 50,000 - 65,000; Full time

Job summary

StarCare Specialty Health System is seeking a full-time Accounts Receivable Coding Specialist to join its Finance team in a hybrid role in Texas. The position focuses on reviewing client accounts, supporting billing and denial specialists, and maintaining a comprehensive coding database to optimize billing across programs.

The ideal candidate has CPC/CCS certification and at least two years in denial management or medical billing, with familiarity in Medicaid/Medicare and CPT/HCPCS coding.

Qualifications

• Minimum two years of experience in denial management, medical billing, or insurance collections
• Familiarity with Medicaid and Medicare billing practices, CPT/HCPCS coding, EMR systems, and managed care contracts preferred
• Must pass pre-employment screenings including drug screen and background checks

Responsibilities

• Maintain a comprehensive database of billing codes across all services and provider types
• Monitor coding updates from CMS, TMHP, and third-party payers and coordinate with staff to update systems and processes
• Review client accounts to ensure accuracy and optimized coding
• Review denied claims from Medicaid/Medicare/private payers to identify trends and resolution opportunities
• Investigate denials and take corrective actions including resubmission or appeals
• Prepare and submit appeals with supporting documentation
• Track appeal outcomes and follow up with payers for timely resolution
• Generate denial management reports for leadership and identify process improvements
• Collaborate with clinical, coding, and AR staff to address documentation or coding issues contributing to denials

Skills

Denial management

Medical billing

Communication

Collaboration

Education

CPC (Certified Professional Coder) or CCS (Certified Coding Specialist) certification

High school diploma or equivalent

Bachelor’s degree in Business/Healthcare (preferred)

Tools

EMR systems

CPT/HCPCS coding

Managed care contracts

Job description

StarCare Specialty Health System (StarCare) is seeking a full-time Accounts Receivable Coding Specialist to join its outstanding Finance team. The Accounts Receivable Coding Specialist is responsible for reviewing and analyzing client accounts, supporting billing and denial specialists, and maintaining a comprehensive database of billing codes across all programs to optimize billing processes. This role is essential in ensuring accurate and timely reimbursement for StarCare while supporting the organization’s financial health by reducing denial rates, improving claim recovery, and ensuring compliance with payer requirements and healthcare regulations.

Responsibilities:

• Maintain a comprehensive database of billing codes across all services and provider types.
• Monitor coding updates from CMS, TMHP, and third-party payers, and coordinate with financial staff to update systems and billing processes accordingly.
• Review and analyze client accounts to ensure accuracy and optimized coding.
• Review and analyze denied claims from Medicaid, Medicare, private insurance, and other third-party payers to identify trends and resolution opportunities.
• Investigate root causes of denials and take corrective actions, including claim resubmission, appeals, or coordination with other departments.
• Prepare and submit appeals with appropriate supporting documentation, ensuring accuracy and timeliness.
• Track appeal outcomes and follow up with payers to ensure timely resolution and maximize reimbursement.
• Collaborate with clinical, coding, and accounts receivable staff to address documentation or coding issues contributing to denials.
• Maintain detailed and organized records of denial activity, appeal status, and resolution outcomes.
• Ensure all denial management activities comply with HIPAA, payer guidelines, and internal policies and procedures.
• Stay informed of changes in payer rules, billing codes, and regulatory requirements that may impact claim processing and denial trends.
• Work closely with accounts receivable staff, clinicians, and administrative teams to implement denial prevention strategies and improve first-pass claim acceptance rates.
• Generate and present denial management reports to leadership, highlighting trends, root causes, and opportunities for process improvement.
• Participate in staff training and contribute to continuous improvement initiatives related to billing accuracy and denial reduction.
• Assist with billing and payment processes as needed, including claim corrections and coordination with the accounts receivable team.
• Maintain regular and consistent attendance for the assigned work hours.
• Ensure all required training and credentials are current and compliant with Center, federal, state, and local regulations, and in addition to StarCare policies and procedures.
• Complete special departmental projects and other responsibilities with similar skill and work conditions as assigned.
• Support all activities in alignment with StarCare’s mission, values, and operational goals.
  

Schedule:

This is a full-time, hybrid, position scheduled Monday – Friday, 8am – 5pm, with flexibility to meet the needs of the department.

Qualifications:

• CPC (Certified Professional Coder) or CCS (Certified Coding Specialist) certification preferred.
• High school diploma or equivalent required.
• Bachelor’s degree in Business, Finance, Healthcare Administration, Accounting, or a related field preferred.
• Minimum of two (2) years of experience in denial management, medical billing, or insurance collections; equivalent combinations of education and experience may be considered.
• Familiarity with Medicaid and Medicare billing practices, CPT/HCPCS coding, EMR systems, and managed care contracts preferred.
• Must have a current Texas driver’s license and be insurable under the Center’s insurance.
• Must pass all pre-employment and annual screenings, including drug screen, criminal background, applicable registry checks, and MVR.

Skills & Abilities:

• Problem Solving: Ability to analyze situations, identify challenges, and develop effective solutions.
• Communication: Strong verbal, written, and electronic communication skills to convey information clearly and professionally.
• Collaboration: Ability to work effectively with others across teams and departments to achieve shared goals.
• Exhibiting Corporate Values: Demonstrates behaviors and decision-making aligned with the organization’s core values and mission.
• Documentation: Proficient in accurately recording, organizing, and maintaining information in various formats.
• Pro ductivity & Reliability: Demonstrates consistent performance, meets deadlines, manages time effectively, and maintains dependability in fulfilling job responsibilities.
• Project and Outcome Management: Ability to plan, execute, and monitor tasks and projects to achieve desired outcomes within established timelines.

Why choose StarCare?

Welcome to StarCare Specialty Health System, where your passion for making a difference thrives! At StarCare, we imagine a community where all people have hope and the opportunity to achieve their full potential for health and wellbeing. Here’s why you should choose StarCare:

• Impactful Purpose: Contribute to meaningful change as the state-designated Local Authority for mental health, intellectual disabilities, and substance use disorders. Be a catalyst for positive empowerment.
• Comprehensive Care: StarCare offers a broad array of specialty healthcare services that support and empower people as valued members of the community.
• Collaborative Environment: StarCare is proud to work with a network of community stakeholders to ensure all people have access to the healthcare they need.
• Professional Growth: StarCare offers many different opportunities for growth in the fields of mental health, substance use disorders, aging, intellectual & developmental disabilities, veterans, and healthcare administration. Come grow your career with us!
• Legacy of Service: Since 1967, StarCare has provided hope and health to Lubbock, Hockley, Lynn, Crosby, and Cochran counties.

At StarCare Specialty Health System , your work is not a job. It’s a fulfilling journey of providing hope and supporting and empowering people as valued members of the community. Ready to get started? We’ve been waiting for you!

EEO Statement:

StarCare Specialty Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.