Revenue Integrity & Reimbursement Specialist

Guthrie; Sayre (Bradford County); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

403(b) Retirement Plan

Employee Assistance Program

Shift Differentials

Friendly, Inclusive Work Family

Job summary

Guthrie in Sayre, PA is seeking a Reimbursement Coordinator to review clinical documentation and accurately assign CPT, ICD-10, and modifiers. You will code multispecialty services and serve as a subject matter expert on documentation guidelines, coding, and reimbursement, collaborating with providers, operational managers, and the CBO to support billing processes.

The role requires strong knowledge of Medicare and Medicaid regulations, CPT/ICD-10-CM, and HCPCS, plus the ability to translate

Qualifications

• Understanding Medicare, Medicaid, and third-party payer coding & billing rules
• Proficient knowledge of CPT, ICD‑10‑CM and HCPCS coding systems and guidelines
• Clinical documentation review for accurate coding and reimbursement
• Effective communication with providers and leadership on coding findings

Responsibilities

• Review clinical documentation to assign CPT, ICD‑10, and modifiers
• Code multispecialty services and works variance coding workqueues
• Perform reimbursement assessments and make recommendations
• Communicate coding review results to stakeholders
• Maintain knowledge of payor regulations and third‑party guidelines
• Contribute to audits of billing activity
• Ensure claims are submitted accurately to payers

Skills

Payer coding & billing knowledge

CPT/ICD-10-CM/HCPCS coding

Medical terminology

Anatomy & physiology

Education

High School Diploma or GED

Health Information Technology degree or RHIA/RHIT/CCS/CPC desirable

CPC certification within 18 months

Job description

Guthrie in Sayre, PA is seeking a Reimbursement Coordinator to review clinical documentation and accurately assign CPT, ICD-10, and modifiers. You will code multispecialty services and serve as a subject matter expert on documentation guidelines, coding, and reimbursement, collaborating with providers, operational managers, and the CBO to support billing processes.

The role requires strong knowledge of Medicare and Medicaid regulations, CPT/ICD-10-CM, and HCPCS, plus the ability to translate