Certified Coding and Billing Compliance Specialist

Jobtailor; Placerville (CA); On-site; USD 75,000 - 105,000; Full time

Job summary

Snowline Health is seeking a Certified Coder and Billing Compliance Specialist to review and code medical records ensuring accurate and compliant billing with Medicare, Medicaid, and private insurers. You will assign ICD-10, CPT, HCPCS, E/M, CCM, and TCM codes while identifying discrepancies before submission.

You will work closely with providers and the billing team to strengthen revenue integrity, support audit readiness, and ensure regulatory compliance, contributing to timely reimbursement

Qualifications

• Certified Professional Coder (CPC) from AAPC or CCS-P from AHIMA with CPT/ICD-10/HCPCS proficiency.
• Minimum 2 years of medical records coding and clinic/billing compliance experience preferred.
• Familiarity with EMR systems and billing platforms.

Responsibilities

• Review and code medical records to ensure accurate, compliant billing per Medicare, Medicaid, and private payers.
• Assign ICD-10, CPT, HCPCS, E/M, CCM, and TCM codes; identify missed or incorrect charges and resolve discrepancies before submission.
• Collaborate with providers and billing team to support documentation integrity, denial prevention, audit readiness and regulatory compliance.

Skills

CPC

CCS-P

EMR familiarity

CMS regulations

HIPAA compliance

Communication

Tools

EMR systems

Billing platforms

Job description

Responsibilities

• The Certified Coder and Billing Compliance Specialist is responsible for reviewing and coding medical records to ensure accurate, compliant billing in accordance with Medicare, Medicaid, and private insurance requirements.
• This role evaluates clinical documentation, assigns ICD-10, CPT, HCPCS, E/M, CCM, and TCM codes, identifies missed or incorrect charges, and resolves coding and claim discrepancies prior to submission.
• The position works closely with providers and the billing team to support documentation integrity, denial prevention and resolution, audit readiness, and regulatory compliance, while providing education and reporting to strengthen revenue integrity.
• Through these efforts, the role helps ensure timely reimbursement and supports the financial sustainability of Snowline Health’s mission-driven care programs.

Qualifications

• Certified Professional Coder (CPC) from AAPC, or Certified Coding Specialist – Physician based (CCS-P) from AHIMA, with proficiency in medical coding systems (CPT, ICD-10, HCPCS).
• Minimum 2 years of experience in medical records coding and clinic/multi-specialty billing compliance preferred.
• Familiarity with Electronic Medical Record (EMR) systems and billing platforms.
• Excellent written and verbal communication is essential for effective collaboration with providers, billing staff, and management.
• Knowledge and practical understanding of CMS regulations and conditions of participation and OIG audit trends, as they relate to Hospice, Palliative Care and In Home Based Primary Care reimbursement models.
• A deep understanding of medical terminology, anatomy, physiology, and pharmacology is essential for accurate interpretation of medical records.
• Excellent attention to detail, analytical and organizational skills.
• Ethical judgment, exercising discretion and maintaining patient confidentiality in accordance with HIPAA.
• Ability to work independently and as part of a team.
• Preferred – CPMA, and CPB certifications.