Medical Biller and Coder Specialist

Eureka Springs Hospital; Eureka Springs (AR); Hybrid; USD 30,000 - 39,000; Part time

Job summary

Eureka Springs Hospital is seeking a part-time Medical Biller and Coder Specialist to translate clinical documents into accurate codes and manage claims end-to-end. The role requires handling ICD-10-CM, CPT, HCPCS coding, denials, and AR follow-up to ensure timely reimbursement.

The hybrid position supports Revenue Cycle workflows and HIPAA-compliant patient data handling, with reports to the Revenue Cycle Director. Prior coding and billing experience is essential for success.

Qualifications

• 2+ years of medical billing and coding experience preferred.
• Experience with ICD-10-CM, CPT, HCPCS coding and denial management.
• Familiarity with HIPAA regulations and payor policies.

Responsibilities

• Review records to assign ICD-10-CM diagnosis codes and CPT/HCPCS codes.
• Prepare and submit clean claims to payers and monitor payments.
• Handle denial management, appeals, and follow-up on aging claims.
• Post payments, apply adjustments, and reconcile accounts.
• Maintain documentation and ensure coding compliance and accuracy.

Skills

ICD-10-CM

CPT coding

HCPCS coding

Denial management

Accounts receivable

HIPAA compliance

Education

CPC/CCS/CBP credentials preferred

Tools

Oracle Community Health

Med Host software

Job description

Job Title: Medical Biller and Coder Specialist

Department: Revenue Cycle

Employment Type:Part – Time

Work Arrangement:Hybrid

Reports To: Revenue Cycle Director

Position Summary

The Medical Biller and Coder is responsible for accurately translating healthcare services and procedures into standardized medical codes and ensuring that claims are properly prepared, submitted, monitored, and reimbursed. This position plays an important role in the revenue cycle by maintaining accurate patient accounts, resolving billing issues, managing insurance claims, and ensuring compliance with applicable coding, billing, and privacy regulations.

The successful candidate will have strong knowledge ofICD-10-CM, CPT, and HCPCS coding, insurance billing procedures, claim submission requirements, payment posting, denial management, and accounts receivable follow-up.

Essential Duties and Responsibilities

Medical Coding

• Review patient medical records, encounter notes, operative reports, diagnostic reports, and other clinical documentation to determine the appropriate diagnosis and procedure codes.
• Assign accurateICD-10-CM diagnosis codes based on provider documentation.
• Assign appropriateCPT and HCPCS codes for services, procedures, supplies, and other billable items.
• Apply appropriate modifiers when supported by documentation and payer requirements.
• Verify that codes accurately reflect the sMedical Biller and Coder Specialistervices documented and meet applicable coding guidelines.
• Identify missing, incomplete, conflicting, or unclear documentation and communicate with appropriate clinical or administrative staff for clarification.
• Review documentation for medical necessity and coding consistency.
• Ensure that diagnoses and procedures are appropriately linked on claims.
• Maintain current knowledge of coding guidelines, payer-specific requirements, annual code changes, and applicable regulatory updates.
• Identify potential coding errors that could result in claim denials, delayed payments, or compliance concerns.
• Assist with internal coding audits and correction of identified coding discrepancies.
• Maintain accurate coding records and documentation.

Medical Billing

• Enter and review patient demographic, insurance, and billing information for accuracy.
• Verify patient insurance eligibility and benefits when required.
• Confirm coverage, referral, authorization, and pre-certification requirements.
• Prepare and submit clean electronic and paper claims to insurance companies and other third-party payers.
• Review claims before submission to ensure required information, codes, modifiers, diagnoses, provider information, and insurance details are accurate.
• Submit corrected claims when errors or omissions are identified.
• Monitor submitted claims and follow up on claims that have not been processed within expected payer timeframes.
• Review payer correspondence, explanation of benefits (EOBs), electronic remittance advice (ERAs), and other payment documentation.
• Post insurance and patient payments accurately to patient accounts.
• Apply contractual adjustments, write-offs, and other account adjustments according to established policies and payer contracts.
• Reconcile payments and investigate discrepancies between billed, allowed, paid, and outstanding amounts.
• Maintain accurate patient account balances.

Denial Management and Accounts Receivable

• Review denied, rejected, and underpaid claims to determine the reason for nonpayment.
• Communicate with uplines and providers on billing or coding errors and resubmit claims as appropriate.
• Research payer policies and claim history to determine appropriate resolution.
• Prepare and submit appeals and supporting documentation for denied or underpaid claims.
• Follow up with insurance companies regarding outstanding claims and appeals.
• Maintain appropriate documentation of claim follow-up activities.
• Work assigned accounts receivable according to established aging and productivity goals.
• Identify recurring denial patterns and communicate trends to management.
• Assist in developing processes to reduce preventable claim denials and improve reimbursement.
• Escalate complex or unresolved payer issues when necessary.
• Monitor aging accounts and prioritize follow-up based on established procedures.

Patient Billing and Account Support

• Respond professionally to patient questions regarding balances, insurance payments, deductibles, co-insurance, and billing activity.
• Explain account activity and insurance processing in understandable terms without providing clinical advice.
• Process patient payments according to established procedures.
• Assist with payment arrangements or financial assistance processes when applicable.
• Maintain accurate documentation of patient communications.
• Protect patient information and follow HIPAA privacy and security requirements at all times.

Compliance and Quality Assurance

• Follow applicable federal and state healthcare regulations and organizational policies.
• Maintain compliance with HIPAA and patient confidentiality requirements.
• Follow established coding and billing standards and internal procedures.
• Ensure that billing and coding are supported by appropriate provider documentation.
• Participate in compliance reviews, audits, and quality assurance activities.
• Report potential compliance concerns to the appropriate supervisor or compliance personnel.
• Maintain secure handling of patient records and protected health information

Experience and Education

• 2+ years of medical billing and coding experience preferred.
• CPC, CCS, or CBP preferred.
• Oracle Community Health and Med Host software experience preferred