Coding Specialist

Emergent Health Partners; Ann Arbor (MI); On-site; USD 60,000 - 80,000; Full time

Job summary

Emergent Health Partners is seeking a Clinical Coding & Charge Entry specialist to assign ICD-10-CM and CPT/HCPCS codes based on clinical documentation and translate transport data into billable charges.

The role includes auditing demographics, verifying insurance eligibility, and ensuring records meet billing guidelines to minimize front-end rejections. Candidates should have strong data entry skills and familiarity with ePCR systems.

Qualifications

• At least 3 years of experience with Medical Insurance.
• Experience with ICD-10-CM coding and CMS billing rules.
• Ability to review clinical narratives for billing accuracy.

Responsibilities

• Assign and sequence ICD-10-CM and CPT/HCPCS codes from clinical documentation.
• Translate transport data into billable charges matching ePCR documentation.
• Maintain up-to-date knowledge of coding bundles, modifiers and global periods to prevent denials.
• Conduct demographic and insurance eligibility audits and verify payer details.
• Review ePCRs for signatures and missing documentation; flag and route send-backs.
• Research and resolve basic claim edits or denials; update notes on rebilled claims.
• Perform data corrections in HealthEMS and related ePCR systems; coordinate via Slack.

Skills

ICD-10-CM coding

CMS billing rules

Medical necessity

Data entry

Problem solving

Written communication

Medical narratives

Organizational skills

Multitasking

Tools

HealthEMS

ePCR programs

Slack

Job description

Clinical Coding & Charge Entry (35% of your time)

• Assign and sequence appropriate ICD-10-CM diagnosis codes and CPT/HCPCS procedure codes based on clinical documentation.
• Translate patient transport data into billable charges, ensuring that the level of service billed perfectly matches the medical necessity documented in the Electronic Patient Care Report (ePCR).
• Maintain a sharp, up-to-date understanding of coding bundling, modifiers, and global periods to proactively prevent claim denials.

Demographic & Insurance Verification (25% of your time)

• Conduct comprehensive audits of patient information, including legal name, address, date of birth, and guarantor details for every claim.
• Verify insurance eligibility and primary/secondary/tertiary coverage using clearinghouses and payer portals.
• Ensure all insurance details are entered flawlessly to minimize "front-end" rejections.

Documentation Compliance & "Send Backs" (20% of your time)

• Review ePCRs for signature compliance and missing clinical documentation.
• Identify and flag incomplete records, preparing "send back" tasks for clinical staff or providers to ensure documentation meets legal and billing guidelines.
• Monitor the "Send Back" queue to ensure corrections are returned and processed quickly.

Claims Resolution & Rebilling (15% of your time)

• Research and resolve basic claim edits or denials related to coding or demographic discrepancies.
• Update account notes to accurately reflect the status of rebilled claims and any actions taken to resolve payment delays.

Systems Maintenance & Team Collaboration (5% of your time)

• Perform critical data corrections within HealthEMS and other ePCR programs.
• Coordinate with providers, clients, and internal colleagues via email and Slack to resolve billing hurdles.
• Stay current on company processes and industry regulatory updates by actively participating in department meetings.

What We’re Looking For

Experience

• At least 3 years of experience with Medical Insurance.

Knowledge, Skills, & Abilities

• Technical Knowledge: Proficiency in ICD-10-CM coding; familiarity with CMS (Medicare/Medicaid) billing rules, private payer regulations, and medical necessity for emergency/non-emergency transport.
• Core Skills: High-speed, high-accuracy data entry; advanced problem-solving; professional written communication; ability to interpret complex medical narratives.
• Key Abilities: A strong ability to maintain deep focus and accuracy during repetitive tasks, and the organizational skill to manage multiple "queues" or task lists simultaneously.

Equal Opportunity Employer
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