Revenue Cycle & Coding Specialist (CPT/ICD-10)

USA Health Systems; Mobile (AL); On-site; USD 40,000 - 60,000; Full time

Job summary

USA Health in Mobile, AL is hiring a Billing and Coding Specialist to manage the reimbursement program, ensure compliance with current payment methodologies, and support accurate coding across Medicare, Medicaid, and commercial payers. You will monitor payer requirements and communicate updates to departments to minimize denials and maximize compliant reimbursement.

You will analyze denial patterns, assist with appeals, train staff, and collaborate with clinical teams to streamline processes,

Qualifications

• High School Diploma or equivalent and 2 years of medical and coding experience required.
• Certification as a Certified Professional Coder within 1 year required.
• Comparable education/experience may substitute for the above requirements.

Responsibilities

• Coordinate and maintain the reimbursement program to ensure compliance with payment methodologies and regulations.
• Monitor Medicare, Medicaid and commercial payer requirements related to documentation, coding, and reimbursement.
• Track regulatory changes affecting billing, collections and reimbursement.
• Communicate billing, coding and reimbursement changes to clinical departments and managers.
• Assist in using CPT, ICD-10-CM, HCPCS for maximum compliant reimbursement.
• Identify and improve processes related to billing, collections, charge capture and reporting.
• Identify adverse trends and recommend corrective actions.
• Identify missed charges and support reimbursement recovery.
• Review third-party payer denials and assist with denial resolution and recovery.
• Assist with appeals when reimbursement is denied.
• Provide reimbursement trend analyses to managers.
• Maintain claim edits and work queues in the practice management system.
• Train new personnel on charge capture and billing requirements.
• Participate in departmental meetings to communicate policy and regulatory changes.
• Maintain knowledge of current reimbursement methodologies and payer requirements.
• Complete all mandatory department and hospital requirements.
• Adhere to Infection Control and Safety Standards.
• Regular attendance and ability to work overtime.
• Related duties as assigned.

Skills

Billing

Coding

Regulatory compliance

Communication

Education

High School Diploma or equivalent

Certified Professional Coder (CPC) within 1 year

Job description

USA Health in Mobile, AL is hiring a Billing and Coding Specialist to manage the reimbursement program, ensure compliance with current payment methodologies, and support accurate coding across Medicare, Medicaid, and commercial payers. You will monitor payer requirements and communicate updates to departments to minimize denials and maximize compliant reimbursement.

You will analyze denial patterns, assist with appeals, train staff, and collaborate with clinical teams to streamline processes,