Hybrid Medical Billing & Coding Specialist

Encova Mutual Insurance Group.; Charleston (WV); Hybrid; USD 44,000 - 70,000; Full time

Benefits offered by this job

Health, Dental & Vision Insurance

401(k) Retirement Plan with company 7%

Paid Time Off and Holidays

Flexible Work Arrangements - Hybrid/ro

Job summary

Encova Insurance is seeking a Medical Bill Adjuster to audit and process complex medical bills across locations with a hybrid (home and Charleston) work arrangement. The ideal candidate will verify coding accuracy, analyze medical records and ensure appropriate billing practices.

The role supports vendor reviews and cross‑functional collaboration. Qualified applicants have a degree and at least three years of medical billing or coding experience, plus coding certifications preferred.

Qualifications

• Associate or bachelor’s degree preferred; commensurate experience may be considered.
• Minimum of three years of experience in medical coding or medical bill processing.
• Certification in medical coding (AAPC or AHIMA) strongly preferred.
• Strong attention to detail and accuracy in coding and billing.
• Extensive knowledge of medical billing, ICD-10, CPT-4, DRG and HCPCS coding.
• Comprehensive understanding of medical invoices and forms.

Responsibilities

• Process medical invoices per pre-determined quota and ensure relation to compensable injury.
• Research medical records to determine appropriate coding and billing.
• Audit and process inpatient hospital bills and higher‑dollar claims.
• Review invoices for correct coding and modifier usage.
• Discuss billing matters with providers, claims adjusters and customers.
• Prepare reports and analyze data related to vendor reviews.
• Identify training needs and support staff with process improvements.
• Perform system testing as needed.

Skills

Medical billing knowledge

Attention to detail

Analytical thinking

Communication skills

Prioritize and manage workload

Education

Associate or Bachelor's degree

Professional coding certification (AAPC/AHIMA)

Tools

ICD-10 coding

CPT-4 coding

DRG knowledge

HCPCS coding

Job description

Encova Insurance is seeking a Medical Bill Adjuster to audit and process complex medical bills across locations with a hybrid (home and Charleston) work arrangement. The ideal candidate will verify coding accuracy, analyze medical records and ensure appropriate billing practices.

The role supports vendor reviews and cross‑functional collaboration. Qualified applicants have a degree and at least three years of medical billing or coding experience, plus coding certifications preferred.