Medical Coder (CPC)

Job Description

Job Description

As a Medical Biller & Coder, you will manage the complete revenue cycle process while providing coding expertise to ensure compliance and accuracy:

• Billing and Revenue Cycle Management: Capturing patient service charges in EPIC, preparing and submitting electronic and paper claims, processing payments from third-party payers and patients, and managing monthly patient statements to ensure optimal revenue collection.
• Medical Coding Excellence: Assigning accurate ICD-10, CPT-4, and HCPCS codes with proper sequencing and modifiers, reviewing and validating coding for denied claims, and serving as a coding resource for the billing department to ensure compliance with regulations.
• Claims Management and Follow-Up: Monitoring open accounts receivable, identifying and correcting claim denials, conducting phone follow-up and online claim status verifications, and performing specialized billing functions such as Medicaid Public Transportation program billing.
• Insurance Operations: Performing insurance verifications for new patients and coverage changes, answering billing and insurance questions from patients, staff, and insurance companies, and resolving patient billing complaints with professionalism and empathy.
• Compliance and Documentation: Providing support to providers on proper coding and documentation practices, researching compliance requirements for provider scope of practice and FQHC guidelines, and maintaining strict adherence to HIPAA guidelines and confidentiality standards.
• System Management: Utilizing EPIC practice management system and Trizetto clearinghouse systems effectively, ensuring maintenance and security of electronic and paper billing records, and participating in system updates and training as needed.

Work Schedule

This is a full-time position with a standard schedule of Monday through Friday, 9:00 AM – 5:00 PM. While the role is primarily remote, occasional on-site presence may be required once a week and for mandatory all-staff or departmental meetings.

Candidates must reside in New York, New Jersey, or Connecticut to be considered.

Education, Experience

• High school diploma required, Bachelor's degree preferred
• Current CPC-A or CPC certification required
• 3+ years medical billing andcoding experience required
• 3+ years experience using EPIC electronic health record
• Thorough understanding and experience with ICD-10, CPT-4, and HCPCS coding systems, FQHC billing guidelines, and healthcare compliance regulations
• Excellent written and verbal communication skills with ability to interact professionally with patients, staff, and insurance representatives
• Must possess absolute commitment to confidentiality, professional integrity, and HIPAA compliance

Desired Characteristics, Skills

• Strong interpersonal and ability to resolve complex billing issues with patience and empathy
• Ability to professionally and diplomatically interact with internal and external stakeholders. Obtains cooperation from and works collaboratively with peers and management. Embraces problems as opportunities to propose and develop solutions.
• Demonstrate enthusiasm for learning and proactively expand knowledge and skills by independently researching new areas of expertise.
• Highly self-motivated, taking initiative to identify needs and respond promptly and effectively.
• Team player with collaborative and supportive approach to work
• Demonstrate cultural competence and a proven ability to work respectfully and effectively with diverse populations, including LGBTQ+ communities and people from various cultural, socioeconomic, and educational backgrounds.
• Commitment to continuous learning and professional development.
• Commitment to community-based healthcare, understanding its vital role in promoting health equity and improving population health outcomes.
• Commitment to the mission of Callen-Lorde.

Benefits

Salary will be based on experience and will be accompanied by a comprehensive benefits package including an exceptional low cost medical plan option for you, your spouse/domestic partner and/or your family, dental insurance, vision insurance, no cost life insurance, short- and long-term disability insurance, Flexible Spending Account, Tuition Assistance, commuter benefits, a generous paid time off plan, and a 403B retirement savings plan. Learn more about our employee benefits https://callen-lorde.org/benefits/

Company DescriptionAbout Us
Callen-Lorde is the global leader in LGBTQ healthcare. Since the days of Stonewall, we have been transforming lives in LGBTQ communities through excellent comprehensive care, provided free of judgment and regardless of ability to pay. In addition, we are continuously pioneering research, advocacy and education to drive positive change around the world, because we believe healthcare is a human right.

Our Mission
Callen-Lorde Community Health Center provides sensitive, quality health care and related services targeted to New York’s lesbian, gay, bisexual, and transgender communities — in all their diversity — regardless of ability to pay. To further this mission, Callen-Lorde promotes health education and wellness, and advocates for LGBTQ health issues.

Our History
Callen-Lorde’s grassroots heritage dates back 50 years to the St. Marks Clinic and the Gay Men’s Health Project – two volunteer-based clinics that provided safe and confidential sexual health and primary care regardless of ability to pay. These clinics merged in 1983 to form Community Health Project, a mostly volunteer-staffed, episodic care program housing the nation’s first community-based HIV clinic.

To learn more about us, visit callen-lorde.org/about

Company Description

About Us\r\nCallen-Lorde is the global leader in LGBTQ healthcare. Since the days of Stonewall, we have been transforming lives in LGBTQ communities through excellent comprehensive care, provided free of judgment and regardless of ability to pay. In addition, we are continuously pioneering research, advocacy and education to drive positive change around the world, because we believe healthcare is a human right.\r\n\r\nOur Mission\r\nCallen-Lorde Community Health Center provides sensitive, quality health care and related services targeted to New York’s lesbian, gay, bisexual, and transgender communities — in all their diversity — regardless of ability to pay. To further this mission, Callen-Lorde promotes health education and wellness, and advocates for LGBTQ health issues.\r\n\r\nOur History\r\nCallen-Lorde’s grassroots heritage dates back 50 years to the St. Marks Clinic and the Gay Men’s Health Project – two volunteer-based clinics that provided safe and confidential sexual health and primary care regardless of ability to pay. These clinics merged in 1983 to form Community Health Project, a mostly volunteer-staffed, episodic care program housing the nation’s first community-based HIV clinic.\r\n\r\nTo learn more about us, visit callen-lorde.org/about