Medical Coder - Billing

About Us: Border Area Mental Health Services, Inc. (BAMHS) dba Southwest Counseling Center (SWCC), is a nonprofit organization providing behavioral and medical health services throughout Southern New Mexico. We are committed to improving the health and well-being of our communities through high-quality, compassionate care.

We are seeking a detail-oriented and experienced Billing & Coding Specialist to join our team.

The Billing & Coding Specialist is responsible for medical coding, claim preparation and submission, payment posting, denial management, collections, account reconciliation, and billing compliance activities. This position plays a critical role in ensuring services are accurately documented, coded, billed, and reimbursed in accordance with payer requirements and applicable regulations.

Review clinical documentation and assign appropriate CPT, HCPCS, ICD-10-CM, and other applicable billing codes.

Verify coding accuracy and compliance with payer requirements, agency policies, and regulatory guidelines.

Prepare and submit electronic claims for medical and behavioral health services.

Review claims for completeness and accuracy prior to submission.

Correct and resubmit denied or rejected claims.

Investigate and resolve billing issues, insurance discrepancies, and claim denials.

Follow up with insurance companies regarding unpaid, denied, or underpaid claims.

Initiate and manage private-pay collection efforts when necessary.

Respond to patient and insurance company inquiries regarding billing matters.

Establish payment arrangements for current and delinquent accounts.

Conduct chart audits to verify coding accuracy, documentation requirements, modifier usage, supervisory requirements, and payer compliance standards.

Identify coding and billing trends that may place the organization at risk for denials, recoupments, or audit findings.

Assist providers and supervisors with understanding documentation requirements needed to support compliant billing practices.

Participate in internal audits, compliance reviews, and quality improvement initiatives.

Assist with reports related to billing, collections, reimbursement trends, coding accuracy, and revenue cycle performance.

Knowledge of healthcare reimbursement and third-party payer regulations.

Knowledge of CPT, HCPCS, and ICD-10-CM coding systems.

Proficiency with electronic health records, billing software, and practice management systems.

Three (3) or more years of medical billing and coding experience.

Bachelor's degree in Business, Healthcare Administration, Health Information Management, or related field.

Experience with behavioral and medical health billing, Medicaid, Medicare, and commercial insurance claims.

Medical, dental, and vision insurance

Paid holidays

Retirement plan options

Health insurance

Life insurance

This position requires prolonged sitting, computer use, standing, walking, bending, and occasional lifting of up to 30 pounds. The work environment is generally quiet and office-based. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the position.

Bachelor's (Preferred)

Medical Coding Certification (CPC, CCS, COC or equivalent) (Preferred)

#