MedFast Urgent Care Centers
*Job Title:*
Billing and Coding Specialist – Urgent Care
*Reports To:*
Billing Manager / Revenue Cycle Manager
*Position Summary:*
The Billing and Coding Specialist ensures accurate assignment of diagnosis and procedure codes for urgent care services to optimize reimbursement and support compliance with regulatory guidelines. This role is responsible for timely charge entry, claim submission, payment posting, denial management, and resolution of billing discrepancies.
*Key Responsibilities:*
*Medical Coding:*
* Review patient charts, documentation, and encounter forms to accurately assign ICD-10-CM, CPT, and HCPCS codes for all services provided in the urgent care setting.
* Validate coding accuracy to ensure compliance with federal, state, and payer-specific regulations.
* Apply appropriate modifiers to support billing requirements.
* Query providers for clarification or additional documentation when necessary.
*Billing and Claims Management:*
* Prepare, review, and submit electronic and paper claims to insurance carriers and third-party payers.
* Monitor claim status to ensure timely reimbursement.
* Follow up on unpaid or rejected claims; correct and resubmit as needed.
* Post payments and adjustments accurately in the billing system.
*Compliance and Auditing:*
* Maintain knowledge of current coding guidelines, payer rules, and reimbursement policies.
* Assist with internal audits to ensure documentation and coding compliance.
* Identify patterns of errors or denials and recommend process improvements.
*Patient and Provider Support:*
* Respond to billing inquiries from patients, insurance companies, and providers in a professional and timely manner.
* Educate providers and staff on documentation requirements to support accurate coding.
*Administrative Duties:*
* Maintain patient confidentiality in accordance with HIPAA and organizational policies.
* Assist with month-end closing, reporting, and reconciliation tasks as assigned.
*Qualifications:*
*Education and Certification:*
* High school diploma or equivalent (required).
* Certified Professional Coder (CPC), Certified Coding Specialist – Physician (CCS-P), or equivalent certification (preferred or required depending on employer).
*Experience:*
* Minimum 1–2 years of medical coding and billing experience, preferably in urgent care, family practice, or emergency medicine settings.
* Familiarity with electronic health records (EHR) and practice management systems (e.g., eClinicalWorks, Athena, NextGen).
*Skills:*
* Strong knowledge of ICD-10-CM, CPT, and HCPCS coding systems.
* Understanding of insurance guidelines and reimbursement processes for commercial payers, Medicare, and Medicaid.
* Attention to detail and high level of accuracy.
* Excellent organizational and time management abilities.
* Effective verbal and written communication skills.
*Working Conditions:*
* This position may be onsite or hybrid depending on organizational policies.
* Standard office hours with occasional extended hours to meet deadlines.
*Physical Requirements:*
* Prolonged periods sitting at a desk and working on a computer.
* Ability to lift up to 15 pounds occasionally.
Job Type: Full-time
Pay: $23.00 per hour
Expected hours: 40 per week
Benefits:
* 401(k)
* 401(k) matching
* Dental insurance
* Employee assistance program
* Flexible schedule
* Health insurance
* Life insurance
* Paid time off
* Vision insurance
Work Location: In person
Billing and Coding Specialist – Urgent Care
*Reports To:*
Billing Manager / Revenue Cycle Manager
*Position Summary:*
The Billing and Coding Specialist ensures accurate assignment of diagnosis and procedure codes for urgent care services to optimize reimbursement and support compliance with regulatory guidelines. This role is responsible for timely charge entry, claim submission, payment posting, denial management, and resolution of billing discrepancies.
*Key Responsibilities:*
*Medical Coding:*
* Review patient charts, documentation, and encounter forms to accurately assign ICD-10-CM, CPT, and HCPCS codes for all services provided in the urgent care setting.
* Validate coding accuracy to ensure compliance with federal, state, and payer-specific regulations.
* Apply appropriate modifiers to support billing requirements.
* Query providers for clarification or additional documentation when necessary.
*Billing and Claims Management:*
* Prepare, review, and submit electronic and paper claims to insurance carriers and third-party payers.
* Monitor claim status to ensure timely reimbursement.
* Follow up on unpaid or rejected claims; correct and resubmit as needed.
* Post payments and adjustments accurately in the billing system.
*Compliance and Auditing:*
* Maintain knowledge of current coding guidelines, payer rules, and reimbursement policies.
* Assist with internal audits to ensure documentation and coding compliance.
* Identify patterns of errors or denials and recommend process improvements.
*Patient and Provider Support:*
* Respond to billing inquiries from patients, insurance companies, and providers in a professional and timely manner.
* Educate providers and staff on documentation requirements to support accurate coding.
*Administrative Duties:*
* Maintain patient confidentiality in accordance with HIPAA and organizational policies.
* Assist with month-end closing, reporting, and reconciliation tasks as assigned.
*Qualifications:*
*Education and Certification:*
* High school diploma or equivalent (required).
* Certified Professional Coder (CPC), Certified Coding Specialist – Physician (CCS-P), or equivalent certification (preferred or required depending on employer).
*Experience:*
* Minimum 1–2 years of medical coding and billing experience, preferably in urgent care, family practice, or emergency medicine settings.
* Familiarity with electronic health records (EHR) and practice management systems (e.g., eClinicalWorks, Athena, NextGen).
*Skills:*
* Strong knowledge of ICD-10-CM, CPT, and HCPCS coding systems.
* Understanding of insurance guidelines and reimbursement processes for commercial payers, Medicare, and Medicaid.
* Attention to detail and high level of accuracy.
* Excellent organizational and time management abilities.
* Effective verbal and written communication skills.
*Working Conditions:*
* This position may be onsite or hybrid depending on organizational policies.
* Standard office hours with occasional extended hours to meet deadlines.
*Physical Requirements:*
* Prolonged periods sitting at a desk and working on a computer.
* Ability to lift up to 15 pounds occasionally.
Job Type: Full-time
Pay: $23.00 per hour
Expected hours: 40 per week
Benefits:
* 401(k)
* 401(k) matching
* Dental insurance
* Employee assistance program
* Flexible schedule
* Health insurance
* Life insurance
* Paid time off
* Vision insurance
Work Location: In person