Senior Medical Billing Coding Specialist

The Medical Billing Coding Specialist Sr. at Catalyst Health Group supports community health by ensuring compliance with documentation and coding during the claims billing process. This role contributes to patient and provider care by upholding core values such as Purpose Driven, Relationships Matter, Serve Others First, and Inspire Creativity.

Responsibilities include:

• Performing paper and EMR chart audits for all providers according to third party and CMS requirements.
• Ensuring charges and billings accurately reflect the medical record using ICD-10, CPT, HCPCS, and CMS guidelines.
• Coordinating and performing professional documentation and coding audits.
• Maintaining up-to-date knowledge of coding guidelines and payer billing rules.
• Developing and delivering education and training programs on coding and documentation.
• Assisting with various audits including hospital visits and reimbursement audits.
• Working with healthcare providers to identify coding compliance and revenue maximization opportunities.
• Preparing monthly operational reports and participating in team and business unit meetings.

Qualifications:

• CPC Certification required.
• Minimum five years of billing, coding, and medical records experience.
• At least two years of insurance resolution experience.
• Broad knowledge of managed care, HMO policies, Medicare benefits, ICD10, CPT, and HCPCS.
• Proficiency with Microsoft Office.

Preferred:

• Associate degree in finance or business.

Catalyst Health Group values making a difference in healthcare delivery and is among the top workplaces in Dallas, focusing on primary care and community health.