Billing & Coding Specialist Job – Dallas, TX

Prism Health North Texas; Dallas (TX); On-site; USD 45,000 - 65,000; Full time

Job summary

Prism Health North Texas is seeking a Billing & Coding Specialist to perform charge capture, coding, billing and reimbursement operations for a multi-specialty, multi-site practice providing medical, dental, and behavioral health services. This role ensures accuracy and timeliness in all aspects of the claim submission process, collaborating with clinic staff and leadership to optimize revenue and compliance.

A certified coder with ambulatory experience is required.

Qualifications

• Certification in Medical and/or Dental Coding required.
• Experience in ambulatory coding and billing for medical/dental/behavioral health.
• Knowledge of CPT/HCPCS/ICD-10 and professional billing terminology.
• Proficient in MS Word, Excel, PowerPoint and Electronic Health Records.
• Strong written and oral communication skills.
• Strong technical and business acumen.

Responsibilities

• Charge capture – ensure completed visits translate into claims or invoices.
• Review coding of each claim before submission to ensure accuracy and completeness.
• Scrub and submit claims via clearinghouse or outsourced billing service; resolve rejections.
• Research and address denials; prepare appeals and identify root causes.
• Identify payments inconsistent with contractual terms/rates and address them.
• Lead, evaluate and maintain billing processes; update SOPs and documentation.
• Develop and lead coding/billing compliance reviews and education for staff.
• Participate in new EHR implementations and billing troubleshooting.
• Monitor dashboards and review accounts receivable with clinic and leadership.
• Collaborate with clinic management, providers and billing services to optimize activities.
• Model professional service; communicate clearly with patients, staff and providers.
• Handle special projects and other duties as assigned.

Skills

Medical Coding

Ambulatory Coding

Billing & Reimbursement

Electronic Health Records

Microsoft Office

Communication

Education

High School Diploma

Associate or Bachelor’s degree preferred

Tools

EHR software

Billing software/clearinghouse

Job description

Our Core Values

The culture at Prism Health North Texas is built on our shared Core Values. We make hiring, firing, promotion and performance review decisions based on these values and behaviors, so it is important that you also share these Core Values:

• We are solution seekers.
• We have a can-do attitude.
• We are mission driven.
• We care about people.

General Description

The Billing & Coding Specialist performs charge capture, coding, billing and reimbursement operations, education on behalf of a multi-specialty, multi-site practice providing medical, dental, and behavioral health services. This role is responsible for ensuring accuracy and timeliness in all aspects of the claim submission process.

Responsibilities

• Charge capture – ensure all completed visits for insured and grant‑eligible medical, behavioral health, and dental patients are translated into claims or invoices.
• Review coding of each claim/invoice before submission to ensure that coding is accurate and complete, billing guidelines are followed, and coding is consistent with medical record documentation of services provided. Recognize when to query provider or clinic staff for further information.
• Scrub and submit claims via clearinghouse and/or outsourced billing service. Monitor, research, correct, and resubmit rejected claims. Address payer edits and other edits/actions as assigned.
• Research and address denials, prepare appeals. Identify and communicate root cause of denials; propose solutions and additional training to minimize denials.
• Identify, research, and address payments inconsistent with contractual terms/rates.
• Lead, evaluate and maintain processes and workflow to ensure efficient and accurate coding and billing. Recommend improvements as noted. Maintain up‑to‑date standard operating procedures and documentation.
• Develop and lead coding and billing compliance reviews anddocumentation education for providers, staff, and leadership.
• Participate in new EHR implementation and billing‑related troubleshooting.
• Monitor billing software dashboards and review accounts receivable with clinic, finance, and other senior leaders.
• Work effectively with clinic management, providers, clinic staff, third party billing services, finance and accounting to optimize billing and coding activities.
• Model the highest level of service and professionalism for both internal and external customers. Communicates clearly and accurately with patients, staff, and providers.
• Special projects and other duties as assigned.

Skills & Qualifications

• Medical and/or Dental Coding Certification required.
• Demonstrated experience in ambulatory practice Procedure, E&M, Medical, Behavioral Health, and/or Dental Coding and Billing practices.
• Demonstrated knowledge of medical, behavioral health, and/or dental professional billing; medical and/or dental terminology; dental coding and/or ICD‑10, CPT, and HCPCS coding.
• Ability to work in MS Word, Excel, PowerPoint, and Electronic Health Records.
• Strong written and oral communication skills.
• Strong technical and business acumen.

Education and Experience

• High School Diploma or equivalent required. Associate or Bachelor’s degree preferred.
• 3 years of experience in medical, behavioral health, and/or dental coding and billing. Experience working with third‑party billing service preferred.
• Work experience in a Federally Qualified Health Center (FQHC) or FQHC look‑alike a plus.
• Work experience with Ryan White and/or Title V funding a plus.