Billing & Coding Coordinator

The Billing & Coding Coordinator is responsible for accurate coding, charge review, risk-adjustment support, and claims coordination within an FQHC environment. This role facilitates communication and workflows with the third-party billing company, ensures compliance with FQHC billing requirements, supports providers with documentation improvement, and participates in revenue cycle special projects.

Key Responsibilities:

• Perform coding review of encounters to ensure accurate CPT, HCPCS, and ICD-10 coding in compliance with payer and FQHC rules.
• Ensure accurate capture of risk-adjusting diagnoses (HCC) and communicate documentation needs to providers.
• Conduct ongoing coding audits and maintain documentation of findings, trends, and corrective action steps.
• Collaborate with the third-party billing company to resolve coding-related denials, edits, and claim rejections.
• Assist in monitoring A/R trends, denial rates, and vendor performance metrics.
• Review charge data for completeness, accuracy, and compliance prior to submission.
• Support month-end close activities including coding reconciliation and reporting.
• Participate in special projects such as workflow redesign, EHR template optimization, payer audits, and regulatory updates.
• Provide coding and documentation guidance to providers and clinical departments.
• Develop and host coding and documentation training sessions for providers and clinical staff to improve coding accuracy, documentation quality, risk-adjustment capture, and compliance.
• Ensure adherence to HRSA, UDS, Medicaid/Medicare, HIPAA, and other regulatory requirements.