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Role Description

The Coding & Billing Specialist is a critical, full-time, salaried position within firsthand’s clinical documentation team. This role is a foundational hire, offering the opportunity to define key processes and program elements for comprehensive and accurate coding of clinical services.

Key Responsibilities

• Coding & Auditing:
  • Perform day-to-day encounter coding for services, procedures, diagnoses, and treatments.
  • Verify that all assigned codes (ICD, CPT, and HCPC) are compatible, appropriate, and accurate for billing.
  • Audit clinical notes for supporting documentation and code to the highest specificity.
  • Use medical terminology to confirm clinical documentation supports the reported diagnoses.
  • Conduct coding corrections.
• Claims & Revenue Cycle Management:
  • Prepare and submit claims for payment.
  • Correct and resubmit rejected claims.
  • Maintain Accounts Receivable (A/R) for revenue cycle management.
• Expertise & Process Improvement:
  • Serve as the subject matter expert on firsthand's billing systems, including the Electronic Health Record (EHR) and Clearinghouses.
  • Advise on and implement ongoing process improvements related to coding and billing.
  • Develop and update procedures manuals to ensure correct coding standards and minimize fraud/abuse risk (e.g., revising the master CPT list).
• Education & Support:
  • Educate firsthand Advanced Practice Nurses (APNs), Nurse Practitioners (NPs), and other team members on proper code selection, documentation, procedures, and requirements.
  • Provide technical guidance to clinical staff in resolving coding issues, such as incomplete or ambiguous documentation.

Qualifications

• 4+ years of experience as a medical billing and coding specialist, leveraging an EHR system.
• A High School diploma or equivalent.
• Required Medical Coder Certification:
  • Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist (CCS) from AHIMA.
• Nice-to-have:
  • Certified Risk Adjustment Coder (CRC) from AAPC.

Requirements

• Strong knowledge of ICD-10-CM and CPT coding guidelines.
• Proficiency in medical terminology, with the ability to read and interpret medical procedures and documentation.
• Expertise in state and federal Medicare reimbursement guidelines.
• Ability to quickly gain proficiency in firsthand’s specific EHR, Clearinghouse, and other billing software.
• Strong multi-tasking skills and consistent attention to detail.
• Excellent written and verbal communication skills for maintaining collaborative relationships with APNs, NPs, the Clinical Documentation Integrity Specialist, and other team members.
• Support firsthand’s mission, vision, and values by demonstrating respect, dignity, empathy, and professional conduct.

Benefits

• Base salary range: $55,000 - $55,000 USD.
• Compensation package includes base, equity (or a special incentive program for clinical roles), and performance bonus potential.
• Benefits include physical and mental health, dental, vision, 401(k) with a match.
• 16 weeks parental leave for either parent.
• 15 days/year vacation in your first year (this increases to 20 days/year in your second year and beyond).
• A supportive and inclusive culture.