Medical Coder and Biller - Team Lead

Summary

Join ReKlame Health as a Medical Coder & Biller - Team Lead and take charge of billing and coding functions, ensuring accuracy and compliance. Lead and oversee all aspects of the billing process, including claims submission and payment processing. Ensure accurate coding with ICD-10, CPT, and HCPCS systems. Monitor and implement changes in Medicare, Medicaid, and other regulatory guidelines. Partner with providers and payers to resolve coding challenges and reduce claim denials. Develop training initiatives to enhance team capabilities. Serve as the expert in coding and billing complexities, particularly in multi-state Medicaid and Medicare nuances. Leverage emerging technologies to optimize billing operations. This role requires a leader who understands coding intricacies and fosters education and mentorship.

Requirements

• Certifications : Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification in medical coding
• Experience : Minimum of 3-5 years of professional experience in medical coding and billing, including expertise with Medicare and Medicaid systems
• Leadership Skills : Demonstrated experience leading and mentoring a team, with a history of improving performance and operational workflows
• Technical Skills : Advanced proficiency with ICD-10, CPT, and HCPCS coding systems and experience with EHR and medical billing software
• Detail-Oriented : Exceptional accuracy and attention to detail in coding/billing and documentation
• Regulatory Knowledge : Strong understanding of HIPAA and healthcare compliance guidelines, with the ability to adapt to changing regulations
• Communication Skills: Exceptional written and verbal communication abilities to effectively collaborate with stakeholders at all levels
• Problem-Solving Expertise: Analytical mindset with the ability to address complex challenges, identify solutions, and implement improvements with speed and accuracy

Responsibilities

• Lead and oversee all aspects of the billing process, including claims submission, payment processing, and account reconciliation, ensuring accuracy and efficiency
• Ensure accurate, compliant coding with ICD-10, CPT, and HCPCS systems to optimize first-pass claim submissions and maximize revenue for patient care and procedures
• Establish scalable workflows to address multi-state billing complexities, with a focus on state-specific Medicaid requirements and streamlined reimbursements
• Monitor and implement changes in Medicare, Medicaid, and other regulatory guidelines, ensuring full compliance across all billing and coding processes
• Conduct regular audits to uphold coding standards, identify gaps, and ensure accurate documentation and billing practices
• Partner with providers, administrative teams, and payers to address documentation gaps, efficiently resolve coding challenges, and reduce claim denials
• Identify skill gaps and develop tailored training initiatives, such as workshops, coaching sessions, and resource playbooks, to enhance team capabilities
• Serve as the expert in coding and billing complexities, particularly in navigating multi-state Medicaid and Medicare nuances
• Leverage emerging technologies and automation tools to optimize billing operations, enhance team performance, and support long-term cost efficiency

Preferred Qualifications

Strong preference for candidates with experience in behavioral health coding

Benefits

• Compensation: $40,000-$60,000
• Full Health Benefits : Medical, dental, and vision
• Paid Time Off (PTO) : 21 days of paid time off, including vacation and sick leave
• Professional Development : Unlock growth opportunities within a purpose-driven early-stage organization dedicated to creating a positive impact