Job Description

LifeWay, Inc. is seeking a knowledgeable, detail-oriented, and highly organized

Billing & Coding Specialist

to support the financial and administrative operations of the practice. This role is essential to ensuring accurate medical coding, timely claims submission, and proper reimbursement while maintaining compliance with all regulatory and payer requirements.

The Billing & Coding Specialist works closely with providers, clinical staff, front-office personnel, and external payers to ensure that services rendered are correctly documented, coded, billed, and reimbursed. The ideal candidate demonstrates strong analytical skills, a high level of accuracy, and a commitment to ethical billing practices and patient confidentiality.

Key Responsibilities

Medical Coding

Review clinical documentation to ensure completeness, accuracy, and compliance prior to coding. Assign appropriate

ICD-10-CM, CPT, and HCPCS

codes for diagnoses, procedures, and services rendered. Ensure coding accuracy in accordance with federal, state, and payer-specific regulations. Apply correct modifiers and units to maximize accurate reimbursement while maintaining compliance. Identify documentation gaps and communicate with providers or clinical staff to obtain clarification when needed. Stay current with coding updates, annual code changes, and regulatory guidelines.
Medical Billing and Claims Processing

Prepare, review, and submit clean claims to insurance companies, Medicare, Medicaid, and other third-party payers. Monitor claims through the full revenue cycle, from submission to payment or denial. Identify and correct claim errors, rejections, and denials in a timely manner. Submit corrected claims and appeals with appropriate documentation and follow-up. Ensure timely billing in accordance with LifeWay, Inc. policies and payer filing deadlines.
Payment Posting and Account Reconciliation

Post payments, adjustments, and contractual allowances accurately to patient accounts. Reconcile Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERA). Identify underpayments or overpayments and take appropriate corrective action. Maintain accurate records of financial transactions within the billing system. Coordinate refunds or account corrections as necessary.
Denial Management and Appeals

Analyze claim denials to identify root causes and trends. Prepare and submit appeals with supporting documentation as required. Track appeal outcomes and follow up with payers to ensure resolution. Collaborate with clinical and administrative staff to reduce recurring denials. Provide feedback and recommendations to improve documentation and billing practices.
Patient Billing and Customer Support

Generate and review patient statements for accuracy and clarity. Respond to patient inquiries regarding bills, insurance coverage, and payment options. Explain billing information in a professional, respectful, and easy-to-understand manner. Set up payment plans or coordinate with management for financial assistance options when appropriate. Maintain a patient-focused approach while ensuring compliance with billing policies.
Compliance and Regulatory Adherence

Ensure all billing and coding practices comply with

HIPAA

,

CMS

,

OIG

, and payer guidelines. Maintain strict confidentiality of patient information at all times. Support audits, reviews, and compliance initiatives as needed. Report potential compliance issues, billing discrepancies, or fraud concerns according to policy. Participate in ongoing training related to healthcare regulations and reimbursement changes.
Reporting and Data Management

Generate billing, coding, and accounts receivable reports as requested. Track key performance indicators such as days in A/R, denial rates, and reimbursement trends. Maintain accurate billing records and documentation for internal and external review. Assist management with financial analysis and revenue cycle improvement initiatives.
Collaboration and Workflow Support

Work closely with providers to ensure documentation supports billed services. Collaborate with front-office staff to verify insurance information and patient eligibility. Coordinate with external billing partners, clearinghouses, or payers as needed. Participate in team meetings, training sessions, and process improvement efforts. Assist with cross-training and coverage for other billing functions when necessary.
Required Qualifications

High school diploma or equivalent required; associate's or bachelor's degree preferred. Previous experience in medical billing and coding within a healthcare setting. Proficiency in

ICD-10-CM, CPT, and HCPCS

coding systems. Strong understanding of insurance billing processes and reimbursement methodologies. Familiarity with Medicare, Medicaid, and commercial insurance plans. Experience using electronic health records (EHR) and medical billing software. Strong attention to detail and organizational skills. Ability to manage multiple tasks and meet deadlines in a fast-paced environment. High level of integrity and commitment to patient confidentiality.
Preferred Qualifications

Professional certification such as

CPC, CCS, CCA, or equivalent

. Experience working in outpatient or specialty medical practices. Knowledge of revenue cycle management best practices. Experience with audits, appeals, and payer negotiations. Bilingual skills are a plus, depending on patient population needs.
Skills and Competencies

Medical coding accuracy and compliance Analytical and problem-solving skills Clear written and verbal communication Patient-focused customer service Organization and time management Ethical judgment and confidentiality Collaboration and teamwork Adaptability to regulatory and payer changes
Work Environment and Physical Requirements

The Billing & Coding Specialist works in a professional medical office or remote/hybrid environment, depending on practice needs. This role involves extended periods of computer use, data entry, and document review. The position requires the ability to focus for prolonged periods and manage detailed information accurately.

Why Join LifeWay, Inc.

LifeWay, Inc. is committed to providing high-quality, compassionate healthcare while maintaining ethical, compliant, and efficient operations. The Billing & Coding Specialist plays a critical role in supporting the financial health of the organization and ensuring patients receive clear, accurate billing services. This position offers the opportunity to grow professionally in a supportive, mission-driven healthcare environment.

Job Types: Full-time, Part-time

Pay: $23.37 - $28.15 per hour

Expected hours: 40 per week

Benefits:

401(k) Dental insurance Flexible schedule Health insurance Health savings account Life insurance Parental leave Professional development assistance Vision insurance
Work Location: Remote