Lead Ambulatory Billing & Coding Specialist

Prism Health North Texas; Dallas (TX); On-site; USD 45,000 - 65,000; Full time

Job summary

Prism Health North Texas is seeking a Billing & Coding Specialist to perform charge capture, coding, billing and reimbursement operations for a multi-specialty, multi-site practice providing medical, dental, and behavioral health services. This role ensures accuracy and timeliness in all aspects of the claim submission process, collaborating with clinic staff and leadership to optimize revenue and compliance.

A certified coder with ambulatory experience is required.

Qualifications

• Certification in Medical and/or Dental Coding required.
• Experience in ambulatory coding and billing for medical/dental/behavioral health.
• Knowledge of CPT/HCPCS/ICD-10 and professional billing terminology.
• Proficient in MS Word, Excel, PowerPoint and Electronic Health Records.
• Strong written and oral communication skills.
• Strong technical and business acumen.

Responsibilities

• Charge capture – ensure completed visits translate into claims or invoices.
• Review coding of each claim before submission to ensure accuracy and completeness.
• Scrub and submit claims via clearinghouse or outsourced billing service; resolve rejections.
• Research and address denials; prepare appeals and identify root causes.
• Identify payments inconsistent with contractual terms/rates and address them.
• Lead, evaluate and maintain billing processes; update SOPs and documentation.
• Develop and lead coding/billing compliance reviews and education for staff.
• Participate in new EHR implementations and billing troubleshooting.
• Monitor dashboards and review accounts receivable with clinic and leadership.
• Collaborate with clinic management, providers and billing services to optimize activities.
• Model professional service; communicate clearly with patients, staff and providers.
• Handle special projects and other duties as assigned.

Skills

Medical Coding

Ambulatory Coding

Billing & Reimbursement

Electronic Health Records

Microsoft Office

Communication

Education

High School Diploma

Associate or Bachelor’s degree preferred

Tools

EHR software

Billing software/clearinghouse

Job description

Prism Health North Texas is seeking a Billing & Coding Specialist to perform charge capture, coding, billing and reimbursement operations for a multi-specialty, multi-site practice providing medical, dental, and behavioral health services. This role ensures accuracy and timeliness in all aspects of the claim submission process, collaborating with clinic staff and leadership to optimize revenue and compliance.

A certified coder with ambulatory experience is required.