Coding & Billing Specialist (part-time)

firsthand supports individuals living with SMI (serious mental illness). Our holistic approach includes a team of peer recovery specialists, benefits specialists and clinicians. Our teams focus on meeting each individual where they are and walking with them side by side as a trusted guide and partner on their journey to better health. firsthand's team members use their lived experience to build trust with these individuals and support them in reconnecting to the healthcare they need, while minimizing inappropriate healthcare utilization. Together with our health plan partners, we are changing the way our society supports those most impacted by SMI. We are cultivating a team of deeply passionate problem-solvers to tackle significant and complex healthcare challenges with us. This is more than a job—it's a calling. Every day, you will engage in work that resonates with purpose, gain wisdom from motivated colleagues, and thrive in an environment that celebrates continuous learning, creativity, and fun. The Coding & Billing Specialist will be a key member of firsthand’s clinical documentation team. As the first hire in this function, the Coding & Billing Specialist will help define key processes and program design elements to support comprehensive and accurate coding for clinical services rendered by firsthand. This role will also be responsible for day-to-day encounter coding, coding audits, coding corrections, claims submission, and more. This is a part-time, hourly position with potential for full-time position based on role performance and workload. As a Coding & Billing Specialist, you will:

• Become subject matter expert in the capabilities of firsthand's billing systems, including EHR and Clearinghouses
• Appropriately codes services, procedures, diagnoses, and treatments. Verifies that the assignment of International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and Healthcare Common Procedural Coding (HCPC) codes are compatible, appropriate, and accurate for billing
• Use medical terminology to understand clinical documentation and determine if it appropriately supports diagnoses. Reviews all individual visit encounters for completeness and accuracy in all services rendered
• Educates firsthand Advance Practice Nurses (APNs), Nurse Practitioners (NPs), and other team members on proper code selection, documentation, procedures, and requirements. Provides technical guidance to APNs, NPs, and other team members in identifying and resolving issues or errors such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, and/or codes that do not conform to approved coding principles/guidelines
• Prepares and submits claims for payment, and corrects rejected claims
• Advises on ongoing process improvements related to coding and billing. Makes recommendations for changes in policies and procedures, e.g., revising the master CPT list. Develops and updates procedures manuals to maintain standards for correct coding, and to minimize the risk of fraud and abuse

You will be a good fit if you:

• Have 4+ years experience as a medical billing and coding specialist leveraging an Electronic Health Record (EHR) system
• Are able to gain proficiency in firsthand EHR, Clearinghouse, and other billing software systems
• Have a strong knowledge of ICD-10-CM and CPT coding guidelines; medical terminology; state and federal Medicare reimbursement guidelines; English grammar and usage
• Are proficient in medical terminology: ability to read and interpret medical procedures and terminology
• Have excellent written and verbal communication skills, especially to maintain working relationships with firsthand APNs, NPs, Clinical Documentation Integrity Specialist, and other team members
• Have strong multi-tasking skills and consistent attention to detail
• Support firsthand’s mission, vision and values: Demonstrates respect, dignity, empathy, and professional conduct to both individuals that firsthand serves and firsthand team members

The required experience you bring to this role includes:

• A high School diploma or equivalent
• Medical coder certification, such as:
• Certified Professional Coder (CPC) from AAPC (American Academy of Professional Coders)Certified Coding Specialist (CCS) from AHIMA (American Health Information Management Association)

Bonus points if you have:

• Certified Risk Adjustment Coder (CRC) certification from AAPC

$18 - $20 an hour

Benefits

For full-time employees, our compensation package includes base, equity (or a special incentive program for clinical roles) and performance bonus potential. Our benefits include physical and mental health, dental, vision, 401(k) with a match, 16 weeks parental leave for either parent, 15 days/year vacation in your first year (this increases to 20 days/year in your second year and beyond), and a supportive and inclusive culture. Vaccination Policy Employment with firsthand is contingent upon attesting to medical clearance requirements, which include, but may not be limited to: evidence of vaccination for/immunity to COVID-19, Hepatitis B, Influenza, MMR, Chickenpox, Tetanus and Diphtheria. All employees of firsthand are required to receive these vaccinations on a cadence/frequency as advised by the CDC, whereas not otherwise prohibited by state law. New hires may submit for consideration a request to be exempted from these requirements (based on a valid religious or medical reason) via forms provided by firsthand. Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption. Note that approvals for reasonable accommodations are reviewed and approved on a case-by-case basis and availability of a reasonable accommodation is not guaranteed. Unfortunately, we are not able to offer sponsorship at this time. Apply tot his job Apply To this Job