Full-Time Care Center Coding & Billing Specialist

Coding and Billing Specialist (Care Center Biller) responsibilities: Complete, accurate, and timely claim processing; reviewing & responding to correspondence from physician practices; providing requested information.

Essential Skills: Strong follow-up skills, attention to detail, solutions-focused mindset, and a driving work ethic.

Job Duties:

• Work directly with physicians & administrators to ensure optimal revenue cycle functionality.
• Understand & explain health plan options/requirements.
• Understand & work with the revenue cycle (scheduling to claim processing).
• Handle backend edits/denials, submitting corrected claims and appeals.
• Create claims & handle frontend edits/denials in EHR system (Athena).
• Review provider documentation, code for services (following payer/coding guidelines, CPT, ICD-10, HCPCS, CMS).
• Query providers for clarification regarding documentation.
• Collaborate with team members to ensure timely & accurate completion of work, providing support as needed.

Education: High school diploma/GED

Experience: 3+ years in a medical billing office; Charge entry experience required; experience with athenaHealth's tools preferred; coding experience & knowledge of CCI edits preferred; CPC or CPC-A certification preferred.

Other Requirements:

• Excellent written & verbal communication.
• Willingness to train & mentor others.
• Strong time management & critical thinking skills.
• Ability to work independently & multitask in a fast-paced environment.
• Technical capability & proficiency.
• Compliance with HIPAA regulations.

Compensation: $20.00-$23.00/hr (base); 10% annual bonus potential.

Remote Work Requirements (if applicable): 5 MBPS download & 3 MBPS upload speed. Internet speed testing is required and reimbursement for internet costs is possible.

Equal Opportunity Employer: Privia Health is an EOE committed to fostering a workplace that reflects the diverse communities we serve.

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