Community Health Programs
Medical Billing & Coding Specialist - Remote
Community Health Programs, Springfield, Massachusetts, us, 01119
About the Organization
Community Health Programs is a network of health centers and caring professionals that provide outstanding primary and preventive care for patients of all ages. What's truly unique to CHP is our broad spectrum of support services that extend beyond medical and dental issues to strengthen families and improve children's well-being. The region is a federally designated rural community and a Medically Underserved Population Area.
Community Health Programs embraces its role as a nonprofit health care provider and community partner. We are a leader in the communities we serve by providing high quality healthcare, dental services, wellness education and family support services. CHP outreach provides free health screenings, insurance enrollment assistance as well as information so people can learn how to take better care of themselves and their families.
Description
Salary Range: $24.00 - $28.00 / hour
The Medical Billing and Coding Specialist is responsible for ensuring the accurate and timely submission of claims through Athenahealth (Athena) to maximize reimbursement and maintain compliance with payer guidelines. While this role includes reviewing coding for claim accuracy, it is primarily focused on end-to-end medical billing functions - including claim submission, insurance follow-up, payment posting, and denial resolution. Familiarity with HCC (Hierarchical Condition Category) coding is helpful to support accurate billing, but the position is not responsible for primary coding entry.
Position Requirements
Medical Billing & Coding Specialist Essential Duties and Responsibilities: Prepare, review, and submit accurate claims through Athena to all insurance payers. Review coding on claims to ensure correctness and compliance before submission. Work claim rejections and denials, identify root causes, and correct or appeal as appropriate. Verify insurance coverage, benefits, and eligibility when needed to support claim resolution. Contact insurance companies and patients to resolve unpaid or underpaid claims. Post and reconcile insurance and patient payments accurately. Monitor claim aging reports and maintain timely follow-up to reduce outstanding A/R. Collaborate with providers and coders to clarify documentation or coding issues that impact billing. Maintain current knowledge of payer rules, FQHC billing requirements, and regulatory updates. Support periodic audits and reports related to billing accuracy and revenue integrity. Competencies:
To perform the job successfully, an individual should demonstrate the following competencies:
Accuracy and accountability in claim processing. Strong follow-through on denials and payer communications. Team collaboration with billing, coding, and clinical departments. Commitment to ethical billing practices and patient confidentiality. Strong understanding of insurance claim workflows, payer requirements, and denial management. Excellent communication and problem-solving skills when working with payers and clinical staff. High attention to detail and ability to manage multiple priorities in a fast-paced environment. Essential Skills and Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Medical Billing & Coding Certification from an accredited association- AAPC, AHIMA etc., required. Minimum of 2 years of medical billing experience, preferably in a primary care or FQHC environment. Work with EHR software proficiently (Athena and Meditech). Familiarity with HCC/risk adjustment and value-based care preferred. Federally Qualified Health Center experience a plus. Education:
High school diploma or GED Associate's degree in medical billing/coding preferred Physical Requirements:
Click here to view the Administrative ADA requirements.
Full-Time/Part-Time Full-Time
Position Medical Billing & Coding Specialist
Exempt/Non-Exempt Non-Exempt
Location Berkshire County
EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.
This position is currently accepting applications.
Community Health Programs is a network of health centers and caring professionals that provide outstanding primary and preventive care for patients of all ages. What's truly unique to CHP is our broad spectrum of support services that extend beyond medical and dental issues to strengthen families and improve children's well-being. The region is a federally designated rural community and a Medically Underserved Population Area.
Community Health Programs embraces its role as a nonprofit health care provider and community partner. We are a leader in the communities we serve by providing high quality healthcare, dental services, wellness education and family support services. CHP outreach provides free health screenings, insurance enrollment assistance as well as information so people can learn how to take better care of themselves and their families.
Description
Salary Range: $24.00 - $28.00 / hour
The Medical Billing and Coding Specialist is responsible for ensuring the accurate and timely submission of claims through Athenahealth (Athena) to maximize reimbursement and maintain compliance with payer guidelines. While this role includes reviewing coding for claim accuracy, it is primarily focused on end-to-end medical billing functions - including claim submission, insurance follow-up, payment posting, and denial resolution. Familiarity with HCC (Hierarchical Condition Category) coding is helpful to support accurate billing, but the position is not responsible for primary coding entry.
Position Requirements
Medical Billing & Coding Specialist Essential Duties and Responsibilities: Prepare, review, and submit accurate claims through Athena to all insurance payers. Review coding on claims to ensure correctness and compliance before submission. Work claim rejections and denials, identify root causes, and correct or appeal as appropriate. Verify insurance coverage, benefits, and eligibility when needed to support claim resolution. Contact insurance companies and patients to resolve unpaid or underpaid claims. Post and reconcile insurance and patient payments accurately. Monitor claim aging reports and maintain timely follow-up to reduce outstanding A/R. Collaborate with providers and coders to clarify documentation or coding issues that impact billing. Maintain current knowledge of payer rules, FQHC billing requirements, and regulatory updates. Support periodic audits and reports related to billing accuracy and revenue integrity. Competencies:
To perform the job successfully, an individual should demonstrate the following competencies:
Accuracy and accountability in claim processing. Strong follow-through on denials and payer communications. Team collaboration with billing, coding, and clinical departments. Commitment to ethical billing practices and patient confidentiality. Strong understanding of insurance claim workflows, payer requirements, and denial management. Excellent communication and problem-solving skills when working with payers and clinical staff. High attention to detail and ability to manage multiple priorities in a fast-paced environment. Essential Skills and Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Medical Billing & Coding Certification from an accredited association- AAPC, AHIMA etc., required. Minimum of 2 years of medical billing experience, preferably in a primary care or FQHC environment. Work with EHR software proficiently (Athena and Meditech). Familiarity with HCC/risk adjustment and value-based care preferred. Federally Qualified Health Center experience a plus. Education:
High school diploma or GED Associate's degree in medical billing/coding preferred Physical Requirements:
Click here to view the Administrative ADA requirements.
Full-Time/Part-Time Full-Time
Position Medical Billing & Coding Specialist
Exempt/Non-Exempt Non-Exempt
Location Berkshire County
EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.
This position is currently accepting applications.