Certified Medical Biller/Coder & Revenue Cycle Manager

Entropy Health•Wyoming, MI

19h•Onsite

About The Position

Focus Clinic is seeking a full-time Certified Medical Biller/Coder & Credentialing Specialist who is organized, proactive, and mission-driven. This is an in-person role in Wyoming, MI, working Monday–Thursday (32 hours/week). You will serve as the comprehensive revenue cycle manager for a rapidly growing clinic, with duties including coding, billing, patient balance follow-up, and compassionate financial guidance for families. The ideal candidate can confidently manage both insurance-billed and cash-pay services, streamline front-desk processes, and help families understand their out-of-pocket expenses with warmth and clarity.

Requirements

Coding certification: AAPC CPC or AHIMA CCS/CCS-P.
Outpatient/clinic revenue cycle experience (billing, coding, A/R follow-up, and patient balances).
Strong understanding of EOBs, denials, payer rules, and patient responsibility (copays, coinsurance, deductibles).
Ability to communicate warmly and clearly with families about finances while holding firm to clinic policies.
High integrity and commitment to compliance, accuracy, and patient experience.

Nice To Haves

TriZetto experience (clearinghouse workflow proficiency).
Experience in eClinicalWorks (eCW).
Experience in pediatric behavioral health / testing-adjacent billing environments (or similarly complex outpatient services).
Process-improvement mindset (clean claim rate, denial reduction, A/R days improvement).
Credentialing experience (provider enrollment + re-credentialing) with demonstrated ability to manage timelines and payer requirements.

Responsibilities

Medical Coding
Accurately code services using CPT/ICD-10 (and modifiers as appropriate) across Focus Clinic’s multidisciplinary offerings (medical visits, diagnostic evaluations/testing, therapy services, and other covered services).
Ensure documentation supports compliant billing and reduces denials.
Billing & Claims Management
Manage end-to-end claims workflow, including charge entry, claim submission, corrections, and resubmissions.
Work within TriZetto (required) and support billing workflows in eClinicalWorks (preferred), including use of eCW’s AI-enabled RCM tools as available.
Monitor A/R, resolve claim issues, and manage denials and appeals through completion.
Patient Balances, Collections Support (Pre-Agency) & Financial Communication
Work patient balances consistently and efficiently up to the point of transferring truly delinquent accounts to the external collections agency.
Support Good Faith Estimates and help families understand expected out-of-pocket costs.
Provide warm, patient-centered financial guidance—including brief scheduled calls with prospective patients who want clarity on costs before booking.
Help families set up appropriate payment plans in accordance with the clinic's policy.
Front Desk Support for Up-Front Collections
Serve as the escalation point when the front desk needs help determining what to collect for new patients or how to handle more complex financial scenarios.
Improve workflows that help the clinic collect accurately and consistently at the time of service.
Credentialing (Optional)
Lead provider credentialing and re-credentialing across payer portals and systems (e.g., CAQH, payer enrollment workflows, roster updates).
Track timelines, maintain credentialing status documentation, and ensure providers remain active and billable with contracted payers.