Hybrid Certified Medical Biller & Coding Specialist

Avenue-360-Health-and-Wellness; Houston (TX); Hybrid; USD 52,000 - 78,000; Full time

Job summary

Avenue 360 in Houston is hiring a Hybrid Certified Biller or Coding Specialist to manage billing for multiple payer types and ensure accurate coding and timely submissions.

You will review claims, resolve denials, perform audits, and educate providers on documentation to improve reimbursement. The role collaborates with clinical and revenue cycle leadership to maintain CMS, Medicaid, Medicare, and managed care compliance.

Qualifications

• Minimum three years of medical billing and/or coding experience.
• Experience interpreting medical documentation and assigning ICD-10-CM, CPT, and HCPCS codes.
• Experience resolving claim edits, denials, and payer rejections.

Responsibilities

• Submit and manage billing for commercial, Medicare, Medicaid, managed care, self-pay, and grant-funded programs.
• Review claims for coding accuracy, billing compliance, and payer-specific requirements prior to submission.
• Resolve billing edits, rejections, denials, and payment variances.
• Perform coding and billing audits to evaluate documentation accuracy and compliance.
• Monitor denial and rejection trends and recommend corrective actions.
• Provide coding and documentation education to providers and clinical staff.
• Present revenue cycle metrics and coding opportunities during meetings.
• Collaborate with clinical, operations, finance, and revenue cycle leadership.

Skills

Billing & coding

Attention to detail

Regulatory compliance

Education

High School Diploma or GED

CPC/CCS/CPB/RHIT/RHIA or equivalent

Tools

Epic

Job description

Avenue 360 in Houston is hiring a Hybrid Certified Biller or Coding Specialist to manage billing for multiple payer types and ensure accurate coding and timely submissions.

You will review claims, resolve denials, perform audits, and educate providers on documentation to improve reimbursement. The role collaborates with clinical and revenue cycle leadership to maintain CMS, Medicaid, Medicare, and managed care compliance.