Biller Coder Liaison

Neighborhood-Healthcare; Escondido (CA); On-site; USD 41,000 - 57,000; Full time

Job summary

Neighborhood Healthcare in Escondido, CA seeks a Biller/Coder Liaison to coordinate coding and billing, resolve denials, and improve revenue cycle performance. You will collaborate with coders, billers, providers, and leadership to ensure accurate claims and compliant processes.

Required: 5+ years in medical billing/coding, EHR/PM experience, and knowledge of payer guidelines. FQHC billing experience is preferred; CPC/CCS/CPB certifications are a plus.

Qualifications

• High school diploma or equivalent required.
• Associate degree preferred in HIM, medical billing, or related field.
• Minimum five years of medical billing/coding or revenue cycle experience.
• FQHC billing experience preferred.
• Experience resolving coding-related denials and edits.
• Experience with electronic health records and practice management systems.
• Certifications CPC, CCS, or CPB preferred.

Responsibilities

• Serve as the primary liaison between Coding and Billing to facilitate communication and issue resolution.
• Research and resolve coding-related billing edits, denials, and claim rejections.
• Review accounts requiring collaboration between coders and billers to determine corrective actions.
• Communicate coding clarification requests to Coding staff and ensure timely resolution.
• Analyze denial trends and identify root causes related to coding, documentation, and payer requirements.
• Partner with Coding leadership to recommend corrective actions and process improvements.
• Assist with payer-specific billing and coding guideline interpretation and implementation.
• Monitor claims requiring coding corrections to ensure timely resubmission and reimbursement.
• Maintain current knowledge of payer specific coding requirements and policies.
• Participate in cross-functional meetings to discuss claim trends, coding issues, payer updates, and workflow improvements.
• Develop and maintain tracking reports for coding-related denials, appeals, and resolution outcomes.
• Educate Billing and Coding staff on payer changes, documentation requirements, and common denial trends.
• Escalate complex reimbursement or compliance concerns to leadership as appropriate.
• Support continuous quality improvement initiatives that enhance clean claim rates and reduce denials.

Skills

Medical Billing

Medical Coding

Revenue Cycle

HIPAA Compliance

Education

Associate degree in HIM/Medical Billing

Tools

Electronic Health Records (EHR)

Practice Management Systems

Job description

Community health is about more than just vaccines and checkups. It’s about giving people the resources they need to live their best lives. At Neighborhood, this is our vision: a community where everyone is healthy and happy. We’re with you every step of the way, with the care you need for each of life’s chapters. At Neighborhood, we are Better Together.

As a private, non-profit 501(C) (3) community health organization, we serve over 500,000 medical, dental, and behavioral health visits from more than 100,000 people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance.

Since 1969, our employees have been making this mission a reality. Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond. If this sounds like an organization you would like to be a part of, we would love to meet you.

ROLE OVERVIEW and PURPOSE

The Biller/Coder Liaison serves as the primary point of collaboration between the Coding and Billing departments to ensure timely, accurate claim submission and reimbursement. This position is responsible for researching coding and billing issues, resolving claim edits and denials related to coding, facilitating communication between teams, and identifying trends that improve revenue cycle performance. The Biller/Coder Liaison works closely with coders, billers, providers, compliance, and leadership to ensure coding accuracy, payer compliance, and optimal reimbursement while supporting Neighborhood Healthcare’s mission of providing high-quality patient care.

RESPONSIBILITIES

• Serve as the primary liaison between the Coding and Billing departments to facilitate effective communication and issue resolution.
• Research and resolve coding-related billing edits, denials, and claim rejections.
• Review accounts requiring collaboration between coders and billers to determine appropriate corrective actions.
• Communicate coding clarification requests to Coding staff and ensure timely resolution.
• Analyze denial trends and identify root causes related to coding, documentation, and payer requirements.
• Partner with Coding leadership to recommend corrective actions and process improvements.
• Assist with payer-specific billing and coding guideline interpretation and implementation.
• Monitor claims requiring coding corrections to ensure timely resubmission and reimbursement.
• Maintain current knowledge of payer specific coding requirements and policies
• Participate in cross-functional meetings to discuss claim trends, coding issues, payer updates, and workflow improvements.
• Develop and maintain tracking reports for coding-related denials, appeals, and resolution outcomes.
• Assist in educating Billing and Coding staff on payer changes, documentation requirements, and common denial trends.
• Escalate complex reimbursement or compliance concerns to leadership as appropriate.
• Support continuous quality improvement initiatives that enhance clean claim rates and reduce denials.
• Maintain confidentiality in accordance with HIPAA and organizational policies.
• Perform other duties as assigned.

EDUCATION/EXPERIENCE

• High school diploma or equivalent required
• Associate degree in Health Information Management, Medical Billing, Healthcare Administration, or related field preferred
• Minimum of five years of experience in medical billing, medical coding, or revenue cycle operations required
• Experience with Federally Qualified Health Center (FQHC) billing preferred
• Experience resolving coding-related denials and claim edits required
• Experience working with electronic health records and practice management systems
• One or more of the following certifications is preferred:
  • Certified Professional Coder (CPC)
  • Certified Coding Specialist (CCS)
  • Certified Professional Biller (CPB)

ADDITIONAL QUALIFICATIONS (Knowledge, Skills and Abilities)

• Excellent verbal and written communication skillswith strongcomposition,typingand proofreading skills
• Knowledge of HIPAA and billing compliance requirements
• Strong attention to detail and accuracy
• Ability to successfully manage multiple tasks
• Excellent planning and organizational skills
• Ability to work independently as well as a teammember

Physical Requirements

• Ability to lift/carry 10lbs/weight
• Ability to stand for long periods of time

COMPLIANCE (Safety & HIPAA)

• Follows all safety procedures as outlined in Neighborhood Healthcare’s Illness and Injury Prevention Plan (IIPP) and report any injuries and/or unsafe conditions immediately
• Maintains current knowledge of policies and procedures as they relate to safe work practices
• Uses appropriate body mechanics to ensure an injury free environment
• Familiarity with location of nearest fire extinguisher and emergency exits
• Follows all infection control procedures including blood-borne pathogen protocols
• Maintains privacy of all patients, employee and volunteer information and access such information only on a need-to-know basis for business purposes
• Complies with all regulations regarding corporate integrity and security obligations
• Reports all behavior and/or activity that are unethical, fraudulent, or unlawful

Pay range: $29.71 to $41.59 per hour depending on experience.

Compensation Disclosure:

The posted salary range reflects the designated pay grade for this position. While this range represents the broader classification of the role, actual compensation will be based on several factors, including but not limited to: the candidate’s overall knowledge, skills, and experience, market data and industry benchmarks, internal equity within the organization, Budgetary considerations and organizational needs. As a result, placement within the range is not guaranteed, and the full pay grade range may not be utilized.

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.