Medical Biller / Coder & Credentialing Specialist

Tucson Dermatology; Tucson (AZ); On-site; USD 45,000 - 60,000; Full time

Benefits offered by this job

Competitive compensation based on experience

Professional and collaborative work environment

Support and improve revenue cycle operations

Job summary

Tucson Dermatology is searching for a Medical Biller / Coder & Credentialing Specialist to manage key functions of the revenue cycle, including accurate coding, claims processing, and provider credentialing. This role ensures compliance with payer requirements and efficient reimbursement processes.

The ideal candidate will have at least 3 years of experience in medical billing and coding with strong knowledge of ICD-10, CPT, and HCPCS coding. A competitive compensation package is offered, including a Monday–Friday schedule and a collaborative work environment.

Qualifications

• Minimum of 3 years experience in medical billing, coding, or revenue cycle management.
• Strong knowledge of ICD-10, CPT, and HCPCS coding.
• Experience in working with insurance payers and claim follow-up.

Responsibilities

• Manage coding accuracy, claims processing, and payer credentialing.
• Prepare and submit electronic claims through the practice management system.
• Monitor and manage accounts receivable and track outstanding balances.

Skills

ICD-10 coding

CPT coding

HCPCS coding

Compliance with billing regulations

Attention to detail

Organizational skills

Education

3+ years in medical billing, coding, or revenue cycle management

CPC, CCS, or equivalent certification

Tools

Experience with EMR systems

Familiarity with Modernizing Medicine (ModMed EMA)

Job description

Location: Tucson

Employment Type: Full-Time

Schedule: Monday – Friday

Position Overview

The Medical Biller / Coder & Credentialing Specialist will manage key functions of the revenue cycle including coding accuracy, claims processing, payer credentialing, denial management, and provider enrollment.

This role works closely with providers, leadership, and clinical teams to ensure accurate billing, compliance with payer requirements, and efficient reimbursement processes.

Key Responsibilities

Medical Coding

• Review provider documentation and assign accurate ICD-10, CPT, and HCPCS codes.
• Ensure coding complies with payer regulations and industry guidelines.
• Identify documentation gaps and communicate with providers when clarification is required.
• Support coding compliance and documentation improvement.

Claims & Billing

• Prepare and submit electronic claims through the practice management system.
• Monitor claim status and follow up on unpaid or denied claims.
• Investigate claim rejections and coordinate corrections with staff.
• Work with clearinghouses and insurance payers to resolve billing issues.

Revenue Cycle Management

• Monitor and manage accounts receivable.
• Track aging reports and follow up on outstanding balances.
• Investigate underpayments and payer discrepancies.
• Support efforts to improve clean claim rate and reduce days in A/R.

Provider Credentialing & Enrollment

• Manage provider credentialing and recredentialing with commercial and government payers.
• Maintain provider enrollment records and credentialing documentation.
• Track credentialing timelines and renewal deadlines.
• Coordinate payer enrollment applications and updates.
• Ensure provider information is accurately reflected in payer systems.
• Work with leadership and providers to ensure timely credentialing during onboarding.

Compliance & Quality

• Maintain compliance with billing regulations and payer policies.
• Support internal billing and coding audits.
• Ensure HIPAA compliance and protection of patient data.

Reporting & Operational Support

• Generate billing, collections, and credentialing status reports.
• Identify opportunities to improve billing workflows and revenue cycle performance.
• Collaborate with leadership to improve operational efficiency.

Qualifications

Required

• Minimum 3 years experience in medical billing, coding, or revenue cycle management.
• Experience with provider credentialing and payer enrollment.
• Strong knowledge of ICD-10, CPT, and HCPCS coding.
• Experience working with insurance payers and claim follow-up.
• Strong attention to detail and organizational skills.

Preferred

• CPC, CCS, or Equivalent Coding Certification.
• Experience in dermatology or outpatient specialty practices.
• Experience with Modernizing Medicine (ModMed EMA) or similar EMR systems.
• Knowledge of dermatology procedures, Mohs surgery billing, or cosmetic services.

Key Competencies

• Strong analytical and problem‑solving abilities.
• Excellent attention to detail.
• Ability to manage multiple priorities and deadlines.
• Strong communication skills with clinical and administrative teams.
• Commitment to compliance and billing accuracy.

What We Offer

• Competitive compensation based on experience.
• Monday–Friday work schedule.
• Professional and collaborative work environment.
• Opportunity to support and improve revenue cycle operations within a growing healthcare organization.