Job Description

The Medical Billing & Coding Specialist will review completed encounters and claims prior to
submission to identify coding, billing, demographic, payer, and claim-form errors. The goal of
this position is to make sure claims are clean and accurate before they are submitted,
reducing denials, rework, and payment delays.
The position is expected to require approximately 1–2 hours per day, with flexibility in
scheduling based on clinic volume.

Key Responsibilities Include: 
● Review completed encounters and claims for accuracy before submission
● Verify that appropriate CPT, HCPCS, ICD-10-CM, and applicable modifiers are used
● Review claims for common billing errors and missing information
● Ensure claims are submitted using the appropriate billing methodology for Rural Health
Clinic (RHC) services
● Review payer-specific requirements and identify potential claim issues before
submission
● Assist with proper billing of Medicare, TennCare/Medicaid, Medicare Advantage,
commercial insurance, and other payers
● Identify claims that may require correction prior to submission
● Review claim edits, rejections, and clearinghouse errors

● Assist with correcting and resubmitting rejected claims when needed
● Monitor recurring denial and rejection trends and communicate issues to clinic
leadership
● Work within eClinicalWorks (eCW) and applicable clearinghouse/payer portals
● Maintain awareness of payer billing and coding requirements
● Assist with periodic review of accounts receivable and outstanding claim issues as
needed
● Communicate with clinic staff regarding documentation or coding issues that could affect
reimbursement
Preferred Qualifications
● 2+ years of medical billing and/or coding experience
● Experience with Rural Health Clinics (RHCs) strongly preferred
● Experience with Medicare RHC billing preferred
● Experience with TennCare/Medicaid and Medicare Advantage billing preferred
● Knowledge of CPT, HCPCS, ICD-10-CM, and medical billing guidelines
● Experience with eClinicalWorks preferred
● Familiarity with electronic claim submission and clearinghouses
● Strong attention to detail
● Ability to identify billing errors and independently research solutions
● Ability to work independently with minimal supervision
● Strong organizational and communication skills

Ideal Candidate
The ideal candidate is someone who understands that getting the claim right before it goes
out is just as important as working the denial afterward.
We are looking for someone who can quickly review our daily claims, identify anything that
doesn't look right, make or recommend the necessary corrections, and help ensure claims are
submitted cleanly.

RHC billing experience is a major plus.

Schedule & Compensation
● Approximately 1–2 hours per day
● Flexible schedule
● Part-time position
● Compensation based on experience and RHC billing/coding expertise

Job Tags

Part time, Flexible hours

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