Hybrid Medical Billing & Coding Specialist

Avenue 360; Houston (TX); Hybrid; USD 55,000 - 75,000; Full time

Job summary

Avenue 360 is seeking a Hybrid Certified Biller or Coding Specialist in Houston to manage the complete billing lifecycle across payer types, ensuring coding accuracy, regulatory compliance, and optimal reimbursement. You will lead audits, address denials, and educate providers to improve documentation quality.

Required are 3+ years in medical billing/coding, CPC/CCS/CPB or RHIT/RHIA certification, and Epic/EHR proficiency. Join a mission-driven FQHC focused on high-quality, accessible care.

Qualifications

• Minimum three (3) 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.
• Knowledge of commercial, Medicare, Medicaid, and managed care billing requirements.
• Experience working within an Electronic Health Record (Epic preferred).

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.
• Provide coding and documentation education to providers and clinical staff.
• Present revenue cycle metrics, billing trends, denial trends, and coding opportunities during Revenue Cycle meetings.
• Maintain compliance with CMS, Medicaid, Medicare, commercial payer, and FQHC billing regulations.

Skills

Medical terminology

Billing & coding knowledge

ICD-10-CM CPT HCPCS coding

Denials analysis

Provider education

Regulatory compliance

Epic/EHR experience

MS Office

Education

CPC/CCS/CPB or RHIT/RHIA or equivalent certification

High School Diploma or GED

Tools

Epic/EHR systems

OCHIN

Job description

Avenue 360 is seeking a Hybrid Certified Biller or Coding Specialist in Houston to manage the complete billing lifecycle across payer types, ensuring coding accuracy, regulatory compliance, and optimal reimbursement. You will lead audits, address denials, and educate providers to improve documentation quality.

Required are 3+ years in medical billing/coding, CPC/CCS/CPB or RHIT/RHIA certification, and Epic/EHR proficiency. Join a mission-driven FQHC focused on high-quality, accessible care.