Billing and Coding Specialist

Billing and Coding Specialist – Job Description 

Employment Type: Full-Time, Exempt 
Level: Associate 
Location: Remote, USA 
Compensation: Starting at $40,000, based on experience

Who we are:  

At Herself Health, we're on a mission to help women get more life out of life, together. We are building a new model of primary care for women 65+ to solve long-standing problems: rushed appointments, long wait times, and care that's generalized rather than specialized towards women’s needs later in life such as post-menopausal care, bone density, weight management, and mental, social and emotional well-being.  

Our patient-centric Primary Care clinics are dispersed across Minneapolis/St. Paul, MN. We are thrilled to serve the Twin Cities metro in our clinics located in Highland Park (St. Paul), Crystal, and South Minneapolis and Rosedale, with our newest clinic in Eagan launching December 2024. Our team of 100+ colleagues is on a mission to innovate the primary care landscape for women 65+. We’re seeking like-minded individuals who share in this passion to join us! 

About you: 

As we grow our early team, we are seeking strategic thought leaders who have a passion for building and innovating. We foster a culture of collaboration, excellence and the willingness to roll up our sleeves and learn as we grow. We have a customer first mindset, and we are looking for team members who share that. Our ideal candidates have strategic prowess and the ability to use data to build best practices and implement great ideas in collaboration with our team and our community.   

About the Billing and Coding Specialist Role:  

The position will report to the Director of Revenue Cycle Management and is responsible for coding encounters that have been signed by the provider. This would include providing education for the physicians. This teammate oversees the timely and accurate coding review of all provider types, while also continuing to identify any new and improved service lines when it comes to monitoring quality of our providers. 

Location Requirements: 

While candidates located in Minnesota are strongly preferred, we welcome applications from individuals who are legally authorized to work in the United States. 

Must-have Qualifications and Skills: 

• Proficient in reading and interpreting medical records to assign accurate medical codes for diagnoses, procedures, and evaluation and management services according to national coding guidelines
• Maintain knowledge of anatomy, physiology, and medical terminology to ensure that diagnoses and services are properly coded
• Review all notes for accuracy and completeness daily
• Obtain missing information from providers and clinical staff members
• Identify all chargeable items within each progress note and ensure proper CPT/CPT II/HCPCS codes for each item
• Accurately assign modifiers
• Review patient claims for demographic and coding accuracy and completeness; obtain and enter any missing demographic information
• Prioritize tasks so that the most important tasks are completed first
• Ensure that all charges are entered, and edits are handled prior to month end
• Works with AR team to monitor denials specific to coding deficiencies, develops and implements methods to decrease denials that directly impact reimbursement for services rendered
• Assists in researching coding and billing issues, and analysis of data for reports
• Knows, monitors, and maintains current knowledge of changes in laws and regulations that affect medical records (health information) management
• Conducts baseline, monthly and quarterly coding reviews of physicians, and conduct the education of good documentation practices; and of coding medical services that are appropriate and accurate, maintaining compliance with CMS guidelines and Federal Rules Regulations
• Acts as a knowledge resource for clinical staff as well as other team members
• Attend team meetings, phone conferences, and training as needed 

Nice-to-have Qualifications and Skills: 

• Highly effective verbal, written and interpersonal communication skills to communicate effectively with all levels of staff and patients
• 2-4 years of physician coding experience, primary care preferred
• Coding certification through AHIMA and/or AAPC
• Auditing experience is a plus
• High level of proficiency in Microsoft Excel, PowerPoint, and Word 
• Ability to interact with providers and provide training and feedback 

We support Equal Employment Opportunities (EEO). We are committed to an inclusive workplace. We do not discriminate based on race, religion, color, national origin, gender identity or expression, age, marital status, veteran status, disability status, parental status, political affiliation, or any other status protected by federal, state, or local laws. 

All employees of Herself Health are expected to fully understand and abide by the practice's compliance policies and procedures. Employees are provided training upon hire and annually and regularly notified of changes as needed. It is expected that all employees will report any suspected violations of any federal or state laws to their direct supervisor, Human Resources, or the Compliance Officer.