Certified Medical Biller/Coder (On-Site)
hace 6 días
Wyoming
Job DescriptionSalary: Competitive Certified Medical Biller/Coder & Revenue Cycle Manager Submissions from recruiters, staffing agencies, or third-party contractors will not be considered. Overview: Focus Clinic is seeking a full-time Certified Medical Biller/Coder & Credentialing Specialist who is organized, proactive, and mission-driven. This is an in-person role in Wyoming, MI, working MondayThursday (32 hours/week). You will serve as the comprehensive revenue cycle manager for a rapidly growing clinic, with duties including coding, billing, patient balance follow-up, and compassionate financial guidance for families. The ideal candidate can confidently manage both insurance-billed and cash-pay services, streamline front-desk processes, and help families understand their out-of-pocket expenses with warmth and clarity. Key Responsibilities: • Medical Coding, • Accurately code services using CPT/ICD-10 (and modifiers as appropriate) across Focus Clinics multidisciplinary offerings (medical visits, diagnostic evaluations/testing, therapy services, and other covered services)., • Ensure documentation supports compliant billing and reduces denials., • Billing & Claims Management, • Manage end-to-end claims workflow, including charge entry, claim submission, corrections, and resubmissions., • Work within TriZetto (required) and support billing workflows in eClinicalWorks (preferred), including use of eCWs AI-enabled RCM tools as available., • Monitor A/R, resolve claim issues, and manage denials and appeals through completion., • Patient Balances, Collections Support (Pre-Agency) & Financial Communication, • Work patient balances consistently and efficiently up to the point of transferring truly delinquent accounts to the external collections agency., • Support Good Faith Estimates and help families understand expected out-of-pocket costs., • Provide warm, patient-centered financial guidanceincluding brief scheduled calls with prospective patients who want clarity on costs before booking., • Help families set up appropriate payment plans in accordance with the clinic's policy., • Front Desk Support for Up-Front Collections, • Serve as the escalation point when the front desk needs help determining what to collect for new patients or how to handle more complex financial scenarios., • Improve workflows that help the clinic collect accurately and consistently at the time of service., • Credentialing (Optional), • Lead provider credentialing and re-credentialing across payer portals and systems (e.g., CAQH, payer enrollment workflows, roster updates)., • Track timelines, maintain credentialing status documentation, and ensure providers remain active and billable with contracted payers. Hours: • Monday through Thursday from 8:00 AM to 5:00 PM. Qualifications: • Required, • Coding certification: AAPC CPC or AHIMA CCS/CCS-P., • Outpatient/clinic revenue cycle experience (billing, coding, A/R follow-up, and patient balances)., • Strong understanding of EOBs, denials, payer rules, and patient responsibility (copays, coinsurance, deductibles)., • Ability to communicate warmly and clearly with families about finances while holding firm to clinic policies., • High integrity and commitment to compliance, accuracy, and patient experience., • Preferred, • TriZetto experience (clearinghouse workflow proficiency)., • Experience in eClinicalWorks (eCW)., • Experience in pediatric behavioral health / testing-adjacent billing environments (or similarly complex outpatient services)., • Process-improvement mindset (clean claim rate, denial reduction, A/R days improvement)., • Credentialing experience (provider enrollment + re-credentialing) with demonstrated ability to manage timelines and payer requirements. Why Join Focus Clinic? • Own the revenue cycle, not just a task list: You will be a key driver of how we code, bill, credential, and communicate financial expectations., • Make finances feel human: Many families reach out because theyre overwhelmed and need clarity. Youll help them understand coverage, out-of-pocket costs, and payment options with warmth, professionalism, and confidence., • Work in a mission-first, faith-based culture: Were serious about excellence, integrity, and compassionand we want our billing experience to reflect the same values as our clinical care., • Collaborate with a multidisciplinary team: You will work closely with providers and the front desk to reduce denials, tighten workflows, and ensure the right amount is collected at the right time., • Stability: This position will stay in-house without outsourcing. About Focus Clinic: Focus Clinic is a faith-based healthcare organization dedicated to helping children with ADHD, learning differences, and behavioral challenges unlock their full potential. We combine medical, psychological, and educational expertise under one roof, offering services that include comprehensive diagnostic assessments, neurofeedback, cognitive therapy, nutritional support, coaching, medication management, and IEP/504 plan advocacy. Our approach is comprehensive, individualized, and strengths-based, designed to support the whole child and uplift every family we serve. Click here to visit our website. Equal Opportunity Employer: Focus Clinic is committed to creating a work environment that reflects the diversity of the children and families we serve. We do not discriminate based on race, color, national origin, religion, gender, gender identity or expression, sexual orientation, age, disability, marital status, veteran status, or any other legally protected characteristic.