Medical Biller & Coder

Astrana Health, Inc.•Spring Valley, NV

22h•$28 - $36•Onsite

About The Position

Astrana Health is seeking a highly organized and detail-oriented Medical Biller & Coder to support accurate, compliant, and efficient revenue cycle operations across multiple payer types, including Medicare, Medicare Advantage, Medicaid Managed Care, and Commercial plans. This role is integral to ensuring timely claim submission, documentation accuracy, risk adjustment integrity, and strong collaboration with clinical and operational teams. This position requires a Las Vegas-based professional who is willing to work onsite during training and periodically thereafter to support provider education, audit feedback, and operational needs. Hybrid or remote work eligibility will be considered after successful completion of training and consistent achievement of defined productivity and quality benchmarks. Our Values Putting Patients First Operating with Integrity & Excellence Being Innovative Working as One Team

Requirements

High school diploma or GED required; Associate’s degree or higher preferred.
Minimum of two (2) years of medical billing and/or coding experience.
Strong working knowledge of CPT, ICD-10-CM, HCPCS, and modifier usage.
Experience with Medicare Advantage, Medicaid Managed Care, and Commercial payers.
Proficiency with EHR and billing systems (e.g., eClinicalWorks).
Strong attention to detail, organization, and follow-through.
CPC, CCS, or CCS-P (AAPC or AHIMA) required.

Nice To Haves

CPB or CMRS preferred.
CRC (Certified Risk Adjustment Coder) preferred.

Responsibilities

Review provider documentation to ensure accurate and compliant assignment of ICD-10-CM, CPT, and HCPCS codes.
Conduct prospective and retrospective medical record reviews, including Risk Adjustment/HCC validation when applicable.
Identify documentation gaps and communicate queries to providers to resolve ambiguous or unsupported coding.
Prepare, review, and submit clean medical claims for primary and secondary payers.
Verify patient insurance eligibility and benefits as needed.
Post payments and adjustments accurately and reconcile billing discrepancies.
Monitor and follow up on rejected, denied, or unpaid claims in accordance with payer guidelines.
Support internal and external audits, data clean-up initiatives, and corrective action plans.
Provide coding, billing, and documentation education to providers individually or in group settings.
Collaborate with clinical, quality, and revenue cycle teams to support compliance and performance goals.
Ensure compliance with HIPAA, CMS regulations, and internal billing and coding policies.