Billing And Coding Coordinator The Billing and Coding Coordinator is responsible for supporting accurate and compliant medical billing and coding activities for Empower "U", Inc., a nonprofit Federally Qualified Health Center (FQHC). This role supports the organization's financial sustainability and compliance with HRSA, CMS, state, and payer-specific requirements by ensuring services are properly documented, coded, and submitted in accordance with applicable guidelines. Working collaboratively with clinical, administrative, finance teams, and external billing partners, the Coordinator focuses on upfront coding accuracy, clean claim submission, and documentation integrity across a diverse payer mix, including Medicaid, Medicare, managed care organizations, commercial insurance, and self-pay programs. This position utilizes Epic EHR workflows and supports audits, site visits, and reimbursement accuracy while denial management and appeals are handled by the organization's contracted billing entity (HCN).
Essential Duties and Responsibilities:
Coordinate daily billing and coding operations using Epic EHR, ensuring accuracy and completeness of claims prior to submission.
Assign and review ICD-10-CM, CPT, and HCPCS codes in accordance with current coding guidelines, payer rules, and FQHC requirements.
Ensure compliance with HRSA, CMS, HIPAA, OIG, and state regulations, including FQHC-specific billing methodologies.
Submit clean and complete claims across multiple payer types, including Medicaid, Medicare (including managed Medicare), commercial plans, and self-pay accounts.
Serve as a liaison with the contracted billing entity (HCN) by providing accurate coding, documentation, and claim-level information as needed to support denial resolution.
Collaborate with providers and clinical leadership to ensure documentation supports billed services and meets medical necessity standards.
Support internal and external audits, site visits, and reviews by providing documentation, reports, and billing data as requested.
Identify billing and coding trends and recommend process improvements to enhance efficiency, compliance, and reimbursement accuracy.
Assist with staff education and informal guidance related to documentation standards, coding accuracy, and Epic billing workflows, as needed.
Generate and review billing and coding reports; communicate findings and issues to leadership as appropriate.
Maintain strict confidentiality of all patient and organizational information.
Perform other duties as assigned in support of departmental and organizational goals.
Required Qualifications:- Associate's degree or equivalent combination of education and experience in Health Information Management, Health Administration, Medical Billing and Coding, or a related field.
- Active professional coding certification required, such as: CPC (Certified Professional Coder) CCS (Certified Coding Specialist) RHIA (Registered Health Information Administrator) preferred but not required
- Minimum of 35 years of experience in medical billing and coding, preferably in an FQHC, nonprofit, or community health setting.
- Demonstrated experience with Epic EHR billing and coding functionality.
- Working knowledge of Medicaid, Medicare, managed care, and commercial insurance billing practices.
- Preferred Knowledge, Skills, and Abilities:
- Knowledge of FQHC billing structures, reimbursement models, and compliance requirements.
- Strong analytical, organizational, and problem-solving skills.
- High level of accuracy and attention to detail.
- Ability to manage multiple priorities and deadlines in a fast-paced environment.
- Effective written and verbal communication skills.
- Ability to work independently while collaborating across departments.
- Commitment to ethical billing and coding practices and the mission of a nonprofit FQHC.Work Environment and Physical Requirements:
- Office-based or hybrid work environment, as determined by organizational needs.
- Prolonged periods of sitting and computer use.
- Must be able to communicate effectively with internal staff and external payer representatives.
- All employees of Empower "U", Inc. are expected to support the organization's mission, values, and commitment to providing high-quality, compliant, and patient-centered care to the community we serve.
- Must be able to pass a Level I and Level II Background check as required.
Empower U Community Health Center, is an equal opportunity employer that is committed to diversity and values the ways in which we are different. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
