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Professional Coder/Biller

5+ years
$50,000 to $70,000 per year
10 Nov. 23, 2024
Job Description
Job Type: Full Time Remote Education: GED/B.Sc./M.Sc./B.Pharm/M.Pharm/Life science Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Why Work Here?

Premier Health is a rapidly growing healthcare management services company offering an excellent work environment, professional development opportunities, and career growth potential.


Position Title: Outpatient Coder/Biller

Location: Remote (Preference for candidates in the Southeast U.S., though not required)


Job Summary

The Outpatient Coder/Biller will ensure the accurate and high-quality coding of all professional outpatient services, including Evaluation & Management (E/M), clinic-based procedures, and ancillary services like laboratory, radiology, physical therapy, and oncology. Additional responsibilities may include inpatient hospital E/M coding and rehab accounts.

The coder/biller will utilize Athena EMR to verify charge and code accuracy, assign appropriate CPT modifiers, manage coding denial work queues, and communicate with clients regarding documentation and coding updates. This role also involves direct client engagement for system setups and implementations.


Key Responsibilities

  • Assign accurate ICD-10-CM and CPT codes for all professional outpatient services, including nursing home visits, laboratory, radiology, and other specialties.
  • Review and validate charges and code assignments using Athena EMR.
  • Add appropriate modifiers to CPT codes.
  • Regularly communicate with clients about coding concerns, incomplete documentation, and policy updates.
  • Resolve coding denials by managing assigned work queues and performing claim appeals.
  • Serve as the primary point of contact for client setups and system implementations.
  • Stay updated on coding and billing guidelines, including payer policies such as LCDs and NCDs.
  • Participate in client setup and implementation, which may involve travel (15–20%).
  • Maintain productivity and quality standards.

Requirements

Education and Certification

  • High school diploma or GED.
  • Completion of an AAPC or AHIMA-approved coding certificate program.
  • One of the following certifications is required:
    • Certified Professional Coder (CPC) – AAPC
    • Certified Coding Specialist (CCS) – AHIMA
    • Certified Coding Associate (CCA) – AHIMA

Experience

  • Minimum 5 years of physician practice coding in an outpatient clinic setting.
  • Minimum 5 years of professional billing, claim denials, appeals, and revenue cycle work.
  • Experience with Athena EMR (required).
  • Familiarity with coding in a provider-based setting is a plus.
  • Project management or client implementation experience preferred.

Skills

  • Expert knowledge of CPT, ICD-10, HCPCS, and medical terminology.
  • Strong understanding of Medicare, Medicaid, and commercial payer guidelines and compliance regulations.
  • Exceptional written and verbal communication skills.
  • Proficient in Microsoft Excel, Word, and PowerPoint.
  • Strong analytical and research skills with extreme attention to detail.
  • Ability to prioritize assignments and meet deadlines.
  • Self-motivated and able to work independently in a remote setting, while also collaborating effectively in a team environment.

Why You'll Love This Role

  • Fully remote position, offering flexibility and work-life balance.
  • Opportunity to work with a growing healthcare management company.
  • Engage in meaningful client interactions and contribute to their success.
  • A chance to enhance your skills through hands-on implementation and coding projects.

About Premier Health

Premier Health is a healthcare management services company dedicated to delivering exceptional solutions for its clients. The organization operates with cutting-edge tools and innovative processes, creating an environment where employees thrive and careers grow.

If you meet the qualifications and are passionate about coding and healthcare management, we encourage you to apply!