Medical Billing Specialist- Certified Coder

Certified Medical Coder & Biller

Are you in search of a fulfilling and meaningful position? Do you want to work for an organization that promotes growth and development?

Here at Men's Health Foundation we envision a world where inequity and stigma do not separate people from healthcare.

"Reimagining Healthcare" is our commitment to affirming the unique experience of every patient. We prioritize our patients' evolving needs and strive to help each patient feel comfortable, understood, and respected.

Why Men's Health Foundation?

Men's Health Foundation is seeking compassionate, mission-driven individuals. We believe that by reimagining how healthcare is delivered, we can help create greater health equity for those most at risk, breaking down barriers to care. We welcome all backgrounds, gender identities, and expressions.

We recognize our staff as the heart of our organization and seek to provide a generous and competitive benefits package to support our employee's well-being. We offer the following:

• Medical, dental, vision, life and LTD insurance (may be eligible on the 1st of the month following date of hire)
• 12 Paid Holidays (including 1 mental health day)
• 401(k) Retirement plan (may be eligible for employer matching up to 4% following completion of 90th day of employment)
• Flexible Spending Account (FSA)
• 40 hours of sick pay (following completion of 90th day of employment)
• 120 hours of PTO accrued within the 1st year of employment

We seek team members who embrace and champion diversity, as our work within the LGBTQ+ community promotes positive sexuality and inclusivity. Candidates should be comfortable with exposure to imagery, events, and materials that reflect our culture of acceptance and expression, ensuring alignment with our values.

Organization Background Men's Health Foundation connects men at risk to comprehensive healthcare and wellness through education, collaboration and advocacy, inspiring and empowering all men to live longer, healthier and happier lives. We see a world where inequity and stigma do not separate men from healthcare. At Men's Health Foundation we are reimagining men's healthcare.

Job Description Overview

We are seeking a detail-oriented and experienced Certified Medical Coder & Biller to join our team. The ideal candidate will have 24 years of hands-on medical coding and billing experience, with a strong understanding of CPT and ICD-10 coding guidelines. This individual must be a self-starter who can work independently with minimal supervision while maintaining accuracy and compliance with all regulatory requirements, including government payer guidelines.

Essential Functions and Responsibilities

• Review and accurately assign CPT, ICD-10, and HCPCS codes to medical procedures and diagnoses.
• Ensure coding accuracy and compliance with federal, state, and payer-specific regulations, including Medicare and Medi-Cal guidelines.
• Submit claims to insurance carriers, including government payers, in a timely and accurate manner.
• Apply proper coding rules specific to Medicare and Medi-Cal claims, including NCCI edits and medical necessity requirements.
• Review and resolve claim edits, rejections, and denials, with a strong focus on government payer denials.
• Perform corrections and rebill claims as necessary.
• Verify documentation supports billed services and coding selections.
• Work closely with providers and clinical staff to clarify diagnoses and procedures.
• Maintain detailed and compliant documentation within the billing system.
• Monitor accounts receivable and follow up on outstanding claims as needed.
• Stay up to date with coding updates, payer policies, including CMS and Medi-Cal regulations.

Qualifications

Required Certification Certified Professional Coder (CPC) through AAPC OR equivalent certification (e.g., CCS, CCA) Candidates with an expired certification number, but with a minimum of three years of relevant coding experience may be considered.

Experience 24 years of medical coding and billing experience required. Proven experience with CPT, ICD-10, and HCPCS coding. Hands-on experience billing and coding for Medicare and Medi-Cal claims, including understanding of payer-specific rules and reimbursement structures. Experience working claim edits, denials, and payer follow-up.

Technical Skills Experience with EHR/EMR systems; familiarity with Allscripts is a plus. Strong knowledge of billing workflows and revenue cycle processes. Proficient in Microsoft Office, especially Excel.

Skills and Abilities Strong attention to detail and accuracy. Ability to work independently with minimal supervision. Excellent problem-solving and analytical skills. Strong organizational and time management abilities. Effective communication skills, both written and verbal. Ability to manage productivity and meet daily/weekly coding and billing targets. Maintain compliance with HIPAA and company policies. Collaborate with cross-functional teams while maintaining accountability for individual workload.

Company Requirements Must be able to pass a pre-employment drug test, physical, and a background check to include a 7-year criminal, 10-year SSN & employer history reference check. Must be able to provide proof of COVID-19 vaccination on the first day of work. Excellent interpersonal skills. Attention to detail. Must be able to work flexible schedules. Must take yearly flu shot or wear flu mask during flu season for patient-facing positions and test for tuberculosis as required by the Centers for Disease Control and Prevention.