Description

 We are committed to supporting at risk children and families providing them with tools and resources to help prevent children from experiencing child abuse, neglect and abandonment. We are a Christian agency that believes in living our mission, we provide Christ-centered care and support to children and families in need.

In response to this community-wide challenge, Presbyterian Children's Homes and Services (PCHAS), provides 14 programs and services in 28 locations, in Missouri, Texas, and Louisiana, which provide children with permanent homes and adults with increased self-sufficiency. This is accomplished by the agency's commitment to "The PCHAS Way" which inspires the agency to be strength-focused, family-centered, and goal driven with every client.

Benefits of serving children and families in need through PCHAS include competitive salaries, flex work schedules, paid time off, medical, dental and vision insurance options, voluntary life insurance options, paid holidays, and a generous 403(b) Retirement Plan (After 1 year of employment, PCHAS provides a 3% contribution and an additional 2:1 match up to an employee's 3% contribution).

Non-Exempt

We are seeking an advanced Medical Biller and Coder with expertise in reviewing complex medical records to assign precise ICD-10/CPT codes, ensuring maximum compliant reimbursement. The ideal candidate will manage the full revenue cycle, including high-level claim denial appeals, auditing records for accuracy, and ensuring strict contract compliance. The role requires proficiency in electronic billing systems, as well as Microsoft Excel and Word. Candidates must be comfortable working in a high-volume, metric-driven environment.

This position reports to the Director of Accounting in Texas.

Essential Job Functions:

Eligibility: Confirm client's insurance eligibility along with copay and deductible information accurately and timely.

Advanced Coding: Analyze provider documentation to assign detailed ICD-10/CPT codes to procedures and diagnoses, ensuring specificity.

Claims Management: Prepare and submit clean claims to insurance companies; manage the appeals process for denied or underpaid claims.

Auditing & Compliance: Conduct internal audits of patient records to ensure compliance with coding guidelines, contract compliance, and federal regulations.

Revenue Cycle Optimization: Identify trends in denials to improve billing accuracy, ensuring optimal reimbursement, and month-end reconciliation.

Communication: Act as a liaison between finance department, program department, counselors, insurance payers, and clients to resolve complex billing discrepancies.

Other duties as assigned.

Working Conditions:

This position requires working in a typical office setting at the office located in Austin, TX, with daily use of the Financial Edge Accounting system and other software, specifically Microsoft Office products. There is occasional need to visit Agency locations and driving on behalf of the Finance department. This position does occasionally require overtime to meet deadlines but is typically an 8-hour day.

This position requires a high-school diploma; vocational and/or some college work preferred with 5 or more years prior experience. Strong computer skills are preferred, particularly with Microsoft Office Excel and Word. This position requires a trustworthy individual who is able to maintain confidences in all areas related to the business and welfare information of the Agency.

Certifications: Active certification from AAPC or AHIMA (e.g., Certified Professional Coder (CPC), Certified Coding Specialist (CCS)) is preferred.

Technical Proficiency: Advanced knowledge of medical billing software and Electronic Health Record (EHR) systems.

Specialty Expertise: Deep knowledge of Medicaid billing and mental and behavioral health coding is preferred.

Analytical Skills: Strong ability to interpret medical documentation and a high level of organization and accuracy.

Other Requirements:

Must hold a valid driver's license, have and maintain a risk-free driving record. Must be willing to undergo initial and periodic child abuse/neglect, criminal history, sexual offender, and childcare/elder care disqualification list screenings. As requested, must submit fingerprints for review by the state of your employment and Federal Bureau of Investigation (FBI).  Must undergo a pre-employment drug screen and a pre-employment physical with the results showing no evidence of communicable disease.

PI284074590