Medical Billing & Coding Specialist

The-Providence-Community-Health-Centers,-Inc.; Warwick (RI); On-site; USD 52,000 - 76,000; Full time

Job summary

The Providence Community Health Centers, Inc. seeks a Revenue Cycle Specialist to manage medical billing, coding and reimbursement for patient care in a busy setting.

You will translate services into ICD-10/CPT/HCPCS codes, submit claims, verify insurance, and follow up on denials to ensure timely payment. Ideal candidates have strong knowledge of HIPAA, CPT/HCPCS and EPIC EHR, with experience in clearinghouse billing and posting payments.

Qualifications

• Proficient in medical terminology including CPT, HCPCS, ICD-10 coding.
• Experience with EPIC EHR, professional billing systems, and web-based applications.
• Certified Professional Coder preferred, with knowledge of CPT/HCPCS and ICD-10 codes.
• Experience in resolving unpaid or denied claims and understanding payer policies.
• Knowledge of electronic/clearinghouse billing software and claim formatting.

Responsibilities

• Translate procedures into ICD-10/CPT/HCPCS codes and modifiers.
• Submit electronic or paper claims to payers.
• Verify patient insurance eligibility and coverage.
• Follow up on denials and unpaid claims to ensure timely reimbursement.
• Post payments and adjustments to patient encounters using billing systems.
• Respond to billing inquiries and resolve discrepancies with patients, payers, and providers.
• Maintain HIPAA compliance and protect patient confidentiality.
• Reconcile encounters and understand EOBs for correct postings.

Skills

Medical terminology

ICD-10 coding

CPT coding

HCPCS coding

EPIC EHR

Billing software

Clearinghouse

Certified Professional Coder

Education

High School diploma or equivalent

Certified Professional Coder (AAPC) preferred

Tools

EPIC EHR

Billing software

Job description

The Providence Community Health Centers, Inc. seeks a Revenue Cycle Specialist to manage medical billing, coding and reimbursement for patient care in a busy setting.

You will translate services into ICD-10/CPT/HCPCS codes, submit claims, verify insurance, and follow up on denials to ensure timely payment. Ideal candidates have strong knowledge of HIPAA, CPT/HCPCS and EPIC EHR, with experience in clearinghouse billing and posting payments.