Senior Medical Billing Specialist

Title: Senior Medical Billing & Coding SpecialistLocation: Charlotte, NC (Onsite)Employment Type: Full TimePay Range: $50,000-$55,000 Per YearPosition SummaryThe Senior Medical Billing & Coding Specialist is responsible for supporting and optimizing the organization’s revenue cycle operations, with a focus on accurate coding, timely billing, and maximizing reimbursement.This role requires strong expertise in FQHC billing methodologies, payer regulations, and coding compliance, along with the ability to identify trends, resolve complex issues, and support overall revenue integrity. Key ResponsibilitiesBilling & Coding Oversight:Perform and review medical coding (CPT, ICD-10, HCPCS) to ensure accuracy and complianceSubmit and reconcile claims in a timely manner, ensuring clean claim ratesMonitor and resolve claim denials, rejections, and underpaymentsFQHC Reimbursement ExpertiseApply knowledge of FQHC billing requirements, including PPS/APM methodologiesEnsure proper use of encounter billing, modifiers, and sliding fee scale structuresSupport billing for integrated services including primary care and behavioral healthAccounts Receivable & Denials ManagementAnalyze A/R reports and aging to identify trends and areas of revenue leakagePerform root-cause analysis on denials and implement corrective actionsCollaborate with internal teams to improve front-end and back-end processesCompliance & Audit SupportEnsure adherence to HRSA, Medicare, Medicaid, and payer-specific regulationsParticipate in internal and external audits; maintain accurate documentationStay current on coding updates and regulatory changesSystems & ReportingUtilize EHR/PM systems (e.g., Athena or similar) for billing, reporting, and workflow managementGenerate reports and provide insights to leadership on revenue cycle performanceCross-Functional CollaborationWork closely with clinical, administrative, and finance teams to improve documentation and workflowsProvide guidance and training on coding and billing best practicesQualificationsRequired:3+ years of medical billing and coding experienceStrong knowledge of CPT, ICD-10, and HCPCS coding systemsExperience with FQHC billing and reimbursement (PPS/APM, encounter billing)Proficiency with EHR/Practice Management systems (Athena preferred)Experience with Medicaid, Medicare, and managed care billingStrong analytical and problem-solving skillsPreferredCPC, CCS, or equivalent certificationExperience in a community health or FQHC settingFamiliarity with behavioral health and integrated care billingKey CompetenciesDetail-oriented with strong accuracy in coding and billingAnalytical mindset with ability to identify and resolve issuesStrong communication and collaboration skillsAbility to manage multiple priorities in a fast-paced environment