Biller Coder

Job Description

Job Description

Description :

Title : Medical Biller & Coder (Cross-Trained in Registration & Education Support)

Department : Revenue Cycle / Business Office

Reports To : Business Office & Billing Operations Manager

FLSA Status : Non-Exempt

Location : Rural Critical Access Hospital / Multi-Clinic Health System

Position Summary

The Medical Biller & Coder is responsible for accurate and compliant coding, charge review, claim preparation, and follow-up to ensure timely reimbursement for hospital and clinic services. This position also plays a critical role in identifying trends, documentation gaps, coding issues, and new regulatory or payer updates—and communicating these findings through staff education.

This position works under the direct supervision of the Business Office & Billing Operations Manager, who provides oversight, training, and direction for all billing, coding, registration cross-training, and revenue cycle improvement efforts.

Because rural hospitals require team members who can flex across departments, this role is also cross-trained in patient registration and may assist with front desk duties as needed to support patient flow and operational coverage.

Essential Duties & Responsibilities

Medical Billing & Coding

• Assign accurate ICD-10, CPT, HCPCS, and modifier codes based on clinical documentation for hospital, RHC, PT / OT, ER, ambulance, and specialty services.
• Review claims for completeness, compliance, and proper charge capture prior to submission.
• Verify medical necessity and ensure documentation supports billed services.
• Monitor queues and clearinghouse rejections and payer denials; correct and resubmit timely.
• Post insurance payments, adjustments, and denials as needed.
• Track coding updates, regulatory changes, payer policy revisions, and CMS guidelines.
• Perform internal audits of clinical documentation to ensure accuracy and compliance.
• Follow all processes, workflows, and directives established by the Business Office & Billing Operations Manager.

Trend Analysis & Quality Improvement

Staff Education & Clinical Support

Cross-Training in Registration & Front-End Duties

Rural Hospital Flexibility & Support

Requirements : Qualifications

Education & Experience :

Knowledge, Skills, & Abilities :

Physical & Work Requirements :

Additional Notes for Rural Healthcare Environment :

This position requires flexibility, teamwork, and a willingness to assist wherever needed to support patient care and financial operations. Job duties may evolve based on organizational needs, new guidelines, or department restructuring. All duties are performed under the guidance and supervision of the Business Office & Billing Operations Manager.