Rancho Health · 1 day ago
Revenue Cycle Billing & Coding
Rancho Health is seeking a RCM Biller/Coder responsible for the accurate coding and billing of professional services. This role ensures timely and compliant claim submission while collaborating with RCM leadership to resolve coding issues and support optimal revenue cycle performance.
Hospital & Health Care
Responsibilities
Accurately assign CPT, ICD-10-CM, and HCPCS codes based on provider documentation and established coding guidelines
Code and bill claims in a timely manner to support clean claim submission and optimal first-pass resolution rates
Manage assigned coding and billing work queues in Athena and Epic in accordance with established workflows and productivity standards
Identify documentation gaps or inconsistencies and route for clarification or correction as appropriate
Review and assist in resolving coding-related denials, medical necessity issues, and payer rejections
Follow up on unpaid or denied claims requiring coding review to support prompt resolution and reduce rework
Respond to internal billing and coding inquiries within defined escalation pathways
Maintain compliance with payer policies, regulatory requirements, and internal RCM standards
Stay current on coding updates, payer policy changes, and regulatory guidance relevant to assigned specialties
Participate in team meetings, training sessions, and quality improvement initiatives as required
Adhere to standardized workflows and documentation practices within Athena and Epic systems
Perform other duties as assigned to support departmental and organizational needs
Qualification
Required
High school diploma or equivalent required
Current coding certification required (CPC, CCS, or equivalent)
Minimum of 2–4 years of medical billing and/or coding experience
Prior experience working in Athena and/or Epic required
Working knowledge of CPT, ICD-10-CM, and HCPCS coding standards
Understanding of payer requirements, claim submission processes, and denial workflows
Strong attention to detail and commitment to accuracy
Ability to manage assigned workloads and meet productivity and quality expectations
Effective written and verbal communication skills
Ability to work independently while collaborating within a team environment
Proficiency navigating Athena and Epic billing and coding workflows
Strong organizational and time-management skills
Preferred
Associate or bachelor's degree in Health Information Management or a related field preferred
Experience in a multi-specialty and/or multi-site environment preferred
Experience supporting denial resolution and claim follow-up preferred