Rural Health Clinic Coder

Elderberry Health

  • Ashland City, TN
  • 30+ days ago

    Highlights

    this position is to make sure claims are clean and accurate before they are submitted, reducing denials, rework, and payment delays. doesn't look right, make or recommend the necessary corrections, and help ensure claims are.

    Numbers & Facts

    LocationAshland City, TN

    Description

    The Medical Billing & Coding Specialist will review completed encounters and claims prior to
    submission to identify coding, billing, demographic, payer, and claim-form errors. The goal of
    this position is to make sure claims are clean and accurate before they are submitted,
    reducing denials, rework, and payment delays.
    The position is expected to require approximately 1–2 hours per day, with flexibility in
    scheduling based on clinic volume.

    Key Responsibilities Include: 
    Review completed encounters and claims for accuracy before submission
    Verify that appropriate CPT, HCPCS, ICD-10-CM, and applicable modifiers are used
    Review claims for common billing errors and missing information
    Ensure claims are submitted using the appropriate billing methodology for Rural Health
    Clinic (RHC) services
    Review payer-specific requirements and identify potential claim issues before
    submission
    Assist with proper billing of Medicare, TennCare/Medicaid, Medicare Advantage,
    commercial insurance, and other payers
    Identify claims that may require correction prior to submission
    Review claim edits, rejections, and clearinghouse errors

    Assist with correcting and resubmitting rejected claims when needed
    Monitor recurring denial and rejection trends and communicate issues to clinic
    leadership
    Work within eClinicalWorks (eCW) and applicable clearinghouse/payer portals
    Maintain awareness of payer billing and coding requirements
    Assist with periodic review of accounts receivable and outstanding claim issues as
    needed
    Communicate with clinic staff regarding documentation or coding issues that could affect
    reimbursement
    Preferred Qualifications
    2+ years of medical billing and/or coding experience
    Experience with Rural Health Clinics (RHCs) strongly preferred
    Experience with Medicare RHC billing preferred
    Experience with TennCare/Medicaid and Medicare Advantage billing preferred
    Knowledge of CPT, HCPCS, ICD-10-CM, and medical billing guidelines
    Experience with eClinicalWorks preferred
    Familiarity with electronic claim submission and clearinghouses
    Strong attention to detail
    Ability to identify billing errors and independently research solutions
    Ability to work independently with minimal supervision
    Strong organizational and communication skills

    Ideal Candidate
    The ideal candidate is someone who understands that getting the claim right before it goes
    out is just as important as working the denial afterward.
    We are looking for someone who can quickly review our daily claims, identify anything that
    doesn't look right, make or recommend the necessary corrections, and help ensure claims are
    submitted cleanly.

    RHC billing experience is a major plus.

    Schedule & Compensation
    Approximately 1–2 hours per day
    Flexible schedule
    Part-time position
    Compensation based on experience and RHC billing/coding expertise

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