Outpatient Medical Coder

Infinit-O is the trusted, customer-centric, and sustainable leader in Business Process Optimization. We empower finance and healthcare organizations to thrive in a digital-first world by combining specialized industry expertise and innovative technology for 20 years. We navigate complex industry landscapes to drive transformative outcomes, helping businesses streamline operations, enhance customer experience, and achieve sustainable growth backed by a world-class Net Promoter Score of 75. Our approach combines operational efficiency with a human-centered ethos, ensuring sustainable value creation for our clients and team members. As a Certified B Corporation, Infinit-O is committed to the highest standards of social and environmental performance, accountability, and transparency. We embed these values into every aspect of our operations—aligning business success with a positive impact on our clients, people, and communities. Our commitment to Diversity, Equity, and Inclusion (DEI) is integral to our mission. We believe that building inclusive, equitable teams is not only the right thing to do—it is also essential for driving innovation and better business outcomes. We actively promote equal opportunity through inclusive hiring practices, continuous learning programs, and regular equity assessments to ensure a fair and empowering workplace for all. Key Responsibilities: The Medical Biller & Certified Coder is responsible for accurate coding, timely claim submission, accounts receivable (AR) management, and denial resolution for inpatient and outpatient practices. This role requires proficiency across multiple EHR platforms and payer portals, including Availity, and the ability to analyze denial trends to improve reimbursement outcomes. The ideal candidate is detail-oriented, analytical, and experienced in end-to-end revenue cycle operations. Key Responsibilities - Coding & Compliance - • Assign accurate ICD-10-CM, CPT, HCPCS, and modifier codes for inpatient and outpatient services in compliance with payer and regulatory guidelines • Review clinical documentation to ensure coding accuracy, completeness, and medical necessity • Independently research and interpret state, federal (CMS), and commercial payer guidelines to support coding, billing, and appeal decisions • Stay current with coding updates, payer policies, and regulatory changes Billing & Claims Management • Prepare, review, and submit clean claims through clearinghouses and payer portals, including Availity • Manage claims across multiple EHR systems and billing platforms • Identify and correct claim errors, edits, and rejections prior to submission Accounts Receivable (AR) • Monitor AR aging reports and follow up on unpaid, underpaid, or delayed claims • Work payer follow-ups via portals, phone, and written correspondence • Ensure timely resolution of outstanding balances and accurate posting of payments and adjustments Denial Management & Trends • Investigate, appeal, and resolve claim denials efficiently and within payer deadlines • Track denial reasons and identify recurring issues or payer trends • Collaborate with internal teams to implement corrective actions and reduce future denials Reporting & Communication • Provide regular reporting on AR status, denial trends, and reimbursement performance • Communicate effectively with providers, clinical staff, and leadership regarding documentation or coding issues • Maintain detailed, accurate documentation of all billing and follow-up activities Requirements Job Requirements and Credentials: • Active medical coding certification (CPC, CCS, CCS-P, or equivalent) • 3+ years of experience in medical billing and certified coding for inpatient and outpatient services • Strong working knowledge of ICD-10-CM, CPT, HCPCS, and modifier usage • Demonstrated proficiency with Availity and other payer portals • Proven experience in AR management and denial resolution • Experience working with multiple EHR systems and billing platforms • Strong analytical skills with the ability to identify trends and process gaps Preferred Qualifications • Experience with hospital-based or multi-specialty practices • Familiarity with Medicare, Medicaid, and commercial payer guidelines • Experience creating or contributing to denial trend analysis and performance improvement initiatives Skills & Competencies • High attention to detail and accuracy • Strong problem-solving and critical-thinking skills • Excellent written and verbal communication • Ability to manage multiple priorities and deadlines • Self-directed with strong organizational skills