Medical Billing, Coding and Compliance Coordinator

Description:

Every Child Pediatrics is looking for a full-time Medical Billing, Coding & Compliance Coordinator to work 40 hours per week on-site, Monday - Friday, at our administrative offices at 9197 Grant St, Thornton, CO 80229. Please note, this is NOT a remote position. The Medical Billing, Coding & Compliance Coordinator is responsible for coordinating day-to-day billing operations and reviewing billing workflows to streamline business operations. In partnership with our third-party billing and coding team, they ensure coding accuracy and compliance to ensure efficient revenue cycle management.

Every Child Pediatrics provides comprehensive, affordable health care to nearly 24,000 Colorado children, regardless of their insurance status or ability to pay. Our experienced professionals focus on the child's overall well-being, providing high-quality medical care, behavioral health counseling, dental care, nutrition, healthy lifestyle programs, and connections to support services such as housing and transportation. As a longstanding nonprofit, we provide unwavering, compassionate care because we believe that every child deserves the best health care and the opportunity to succeed.

Responsibilities:

Billing & Coding

• Serve as the main point of contact between Every Child Pediatrics and the third-party billing and coding team; monitor their progress on missing slips and timely claim submission.
• Audit internal billing and coding processes and coordinate external audits with AAPC/vendors.
• Provide feedback to providers and the third-party billing team based on audit findings.
• Review, analyze, and trend denials and provide feedback to leadership/providers/billing team as necessary.

Credentialing & Compliance

• Process payer and location credentialing, including updates in our EHR, Athena.
• Maintain and update Commercial and Medicaid Fee Schedules in Athena.
• Maintain and update payer portal access and administrator roles.
• Ensure compliance with Colorado Medicaid and other payer requirements.

Financial Operations Support

• Assist with insurance verification, EOB tracking, and unpostable payments.
• Coordinate with finance on voided checks, reconciliation, and payment disputes.
• Handle credit card disputes and collect copays via phone.
• Support month-end close processes and reporting.

Collaboration & Communication

• Collaborate with the Director of Operations and other members of leadership to review and improve workflows to optimize efficiency and accuracy of billing, coding and claims collection.
• Collaborate with internal staff to ensure updates for new orders are mapped correctly with accurate billing codes and pricing.
• Oversee insurance company relationships, including rate issues, reconsiderations, and appeals.
• Serve as the main point of contact for patient billing questions, setting up payment plans, returning patient phone calls, and updating patient insurance information in the EHR.

Requirements:

• Bilingual in English and Spanish
• High School Diploma/GED
• Certification in medical billing/coding and/or 5-7 years hands-on medical billing experience in a healthcare setting
• Knowledge of CO Medicaid, CPT, & ICD-10
• Experience with an EHR; athenahealth system experience preferred
• Advanced experience with Excel
• Strong attention to detail with great time-management, organizational, and communication skills
• Understanding of HIPAA regulations and the ability to handle sensitive information and protect patient confidentiality
• Commitment to Every Child Pediatrics' mission and core values

About Us:

Every Child Pediatrics is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by law.

H.E.A.L.T.H. represents our core values: Health Care Integration, Equity & Inclusivity, Accessibility & Affordability, Love, Team, High Standards

To learn more about our organization, please visit our website at

Benefits:

We offer a robust benefits package to support our employees' well-being, including: a 401(k)-retirement plan with a company match; medical, dental, and vision insurance; Health Savings and Flexible Spending/Dependent Care Accounts (HSA & FSA) for managing healthcare expenses. Additionally, we pay for employees' life insurance and employee assistance plans, and employees accrue Paid Time Off (PTO), allowing them time needed to recharge and focus.

Requirements:

Compensation details: 24-28 Hourly Wage

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