Coding and Billing Specialist

firsthand Health • New York, NY

1d • $55,000 - $55,000

About The Position

firsthand supports individuals living with SMI (serious mental illness). Our holistic approach includes a team of peer recovery specialists, benefits specialists and clinicians. Our teams focus on meeting each individual where they are and walking with them side by side as a trusted guide and partner on their journey to better health.
firsthand's team members use their lived experience to build trust with these individuals and support them in reconnecting to the healthcare they need, while minimizing inappropriate healthcare utilization. Together with our health plan partners, we are changing the way our society supports those most impacted by SMI.
We are cultivating a team of deeply passionate problem-solvers to tackle significant and complex healthcare challenges with us. This is more than a job—it's a calling. Every day, you will engage in work that resonates with purpose, gain wisdom from motivated colleagues, and thrive in an environment that celebrates continuous learning, creativity, and fun.
Coding & Billing Specialist Role: The Coding & Billing Specialist is a critical, full-time, salaried position within firsthand’s clinical documentation team. This role is a foundational hire, offering the opportunity to define key processes and program elements for comprehensive and accurate coding of clinical services.

Requirements

• 4+ years of experience as a medical billing and coding specialist, leveraging an EHR system.
• A High School diploma or equivalent.
• Required Medical Coder Certification: Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist (CCS) from AHIMA.
• Strong knowledge of ICD-10-CM and CPT coding guidelines.
• Proficiency in medical terminology, with the ability to read and interpret medical procedures and documentation.
• Expertise in state and federal Medicare reimbursement guidelines.
• Ability to quickly gain proficiency in firsthand’s specific EHR, Clearinghouse, and other billing software.
• Strong multi-tasking skills and consistent attention to detail.
• Excellent written and verbal communication skills for maintaining collaborative relationships with APNs, NPs, the Clinical Documentation Integrity Specialist, and other team members.
• Support firsthand’s mission, vision, and values by demonstrating respect, dignity, empathy, and professional conduct.

Nice To Haves

• Certified Risk Adjustment Coder (CRC) from AAPC.

Responsibilities

• Perform day-to-day encounter coding for services, procedures, diagnoses, and treatments.
• Verify that all assigned codes (ICD, CPT, and HCPC) are compatible, appropriate, and accurate for billing.
• Audit clinical notes for supporting documentation and code to the highest specificity.
• Use medical terminology to confirm clinical documentation supports the reported diagnoses.
• Conduct coding corrections.
• Prepare and submit claims for payment.
• Correct and resubmit rejected claims.
• Maintain Accounts Receivable (A/R) for revenue cycle management.
• Serve as the subject matter expert on firsthand's billing systems, including the Electronic Health Record (EHR) and Clearinghouses.
• Advise on and implement ongoing process improvements related to coding and billing.
• Develop and update procedures manuals to ensure correct coding standards and minimize fraud/abuse risk (e.g., revising the master CPT list).
• Educate firsthand Advanced Practice Nurses (APNs), Nurse Practitioners (NPs), and other team members on proper code selection, documentation, procedures, and requirements.
• Provide technical guidance to clinical staff in resolving coding issues, such as incomplete or ambiguous documentation.

Benefits

• For full-time employees, our compensation package includes base, equity (or a special incentive program for clinical roles) and performance bonus potential.
• Our benefits include physical and mental health, dental, vision, 401(k) with a match, 16 weeks parental leave for either parent, 15 days/year vacation in your first year (this increases to 20 days/year in your second year and beyond), and a supportive and inclusive culture.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED