Indiana Regional Medical Center ยท 2 months ago
Rural Health Clinic Billing Coordinator PAH
Indiana, PA
Full-time
Onsite
Mid LevelIndiana Regional Medical Center is seeking a Rural Health Clinic Billing & Coding Specialist responsible for overseeing billing, coding, and compliance functions specific to Rural Health Clinics. This role ensures accurate claim submission and maximizes reimbursement while providing training and support for RHC billing processes.
Hospital & Health Care
Responsibilities
Accurately review and submit RHC claims in accordance with CMS, Medicaid, and commercial payer requirements
Monitor encounter-based billing processes to ensure compliance with RHC reimbursement methodologies
Resolve denials, rejections, and claim edits in a timely manner
Ensure billing practices comply with RHC-specific CMS/Medicaid regulations
Stay current with regulatory updates affecting RHC operations and communicate changes to leadership and staff
Support internal audit readiness and assist with external audits as needed
Develop and implement billing workflows and processes for new RHC locations
Collaborate with leadership, providers, and operational staff to ensure revenue cycle readiness from day one
Train and mentor billing and coding staff on RHC-specific requirements
Develop written guidelines, reference materials, and training sessions to expand organizational expertise
Track billing performance metrics (e.g., clean claim rate, denial rate, days in A/R)
Provide regular reporting to leadership on reimbursement trends and compliance status
Recommend process improvements to enhance efficiency and collections
Qualification
Required
Demonstrated experience with Rural Health Clinic billing and coding
Strong understanding of Medicare and Medicaid RHC guidelines and encounter-based billing
Knowledge of CPT, HCPCS, ICD-10 coding, and payer billing systems
Experience with claim denials, appeals, and revenue cycle problem-solving
Proficiency in electronic health records (EHR) and billing systems
Certification in medical coding (e.g., CPC, CCS, or equivalent)
Certified Rural Health Clinic Professional (CRHCP)
Experience training staff in billing and coding practices
Strong analytical and communication skills
Company
Indiana Regional Medical Center
Indiana Regional Medical Center, 194-bed not-for profit community hospital, has been serving Indiana County and surrounding communities since 1914.
Founded in 1914
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Michael Ickowski, CPA, MBA
CFO - Pennsylvania Mountain Care Network
Brett Braun
Chief Operating Officer
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