The HealthCare Connection · 2 days ago
Billing & Coding Analyst
The HealthCare Connection is Ohio’s first Federally Qualified Health Center, dedicated to providing quality primary healthcare services. The Billing & Coding Analyst is responsible for accurate coding, charge review, risk-adjustment support, and claims coordination within an FQHC environment, ensuring compliance with billing requirements and supporting providers with documentation improvement.
DentalHealth CareMedicalPrimary and Urgent Care
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
Qualification
Required
High school diploma required; associate degree in health information, billing, or related field preferred
Certified coder required (CPC, CCS, or equivalent)
Minimum 2 years of medical billing and coding experience; FQHC experience strongly preferred
Knowledge of CPT, HCPCS, ICD‑10, PPS/GFQHC billing rules, Medicaid, Medicare, and commercial payer requirements
Strong communication skills, attention to detail, and ability to collaborate with clinical, administrative, and external teams
Proficiency with EHR and billing software systems
Preferred
Associate degree in health information, billing, or related field
Experience or training in risk‑adjustment coding; CRC preferred or willingness to obtain within 12 months
Risk‑adjustment coding certification (CRC)
Experience coordinating with external billing vendors
Experience with NextGen and EPIC
Benefits
Health Insurance and Rewards Program
Dental, and Vision Insurance
Free Life & Short-Term Disability Insurance
403(b) Retirement Plan with employer match
Comprehensive Paid Time Off (PTO)
10 Paid Holidays