Eligibility / Qualification Required:
Key Responsibilities- Own CPT/ICD-10 coding and strategy across psychiatry and medication management, with a focus on high-acuity and complex patient populations.
- Review clinical documentation (eg SOAP notes) and supporting information to ensure clean claim submission.
- Improve first-pass claim acceptance by proactively ensuring correct coding, flagging inconsistencies, and documenting gaps for correction.
- Audit & Quality Review Support
- Perform pre-bill and post-pay audits on a rolling basis.
- Review EOBs and denial trends to identify recurring coding issues.
- Document audit findings using structured templates and tracking tools.
- Flag systemic risks to improve the process and escalate high-risk patterns or unusual payer behavior when necessary.
- Work closely with billing team members, senior management, and vendors to resolve claim issues.
- Support coding corrections and resubmissions, provide clarification, and maintain internal reference guides for other team members when necessary.
- Compliance & Coding Standards
- Ensure compliance and alignment with CMS, state Medicaid, and managed-care guidelines.
- Monitor changes in payer policies and stay up to date on behavioral health and psychiatry guidelines.
- Partner with the credentialing and billing teams on implementing new payer contracts and RCM workflows.
You will love this role if:
- Certifications: Certified Professional Coder (CPC) or Certified Coding Specialist (CCS).
- Technical Skills: Advanced proficiency with ICD-10, CPT, and HCPCS coding systems. Experience working with EHR systems, clinical notes, and medical billing software required.
- Experience working with RCM and billing vendors is a strong plus.
- Experience: Minimum of 3-5 years of professional experience in medical coding and billing required.
- Strong preference for candidates with experience in behavioral health coding and expertise in Medicaid and managed-care systems.
- Detail-Oriented: Exceptional accuracy and attention to detail in coding/billing and documentation.
- Regulatory Knowledge: Strong understanding of HIPAA and healthcare compliance guidelines, with the ability to adapt to changing regulations.
- Experience with denial resolutions, coding audits, and QA review preferred.
- Problem-Solving Expertise:Analytical mindset with the ability to address complex challenges, identify solutions, and implement improvements with speed and accuracy. Must be comfortable with EOBs, patterns, and payer behavior.
If you’re hungry for a challenge in 2026, love solving problems, and want to be a part of something transformational, we’d love to hear from you!
Learn more about us at
www.ReKlamehealth.com_*We never ask for money or sensitive personal information during the job application process. If you receive an email or message claiming to be from us that requests such information, please do not respond and report it as a scam._
ReKlame Health considers several factors to ensure a fair and competitive offer when evaluating compensation packages. These include the scope and responsibilities of the role, the candidate's work experience, education, and training, as well as their essential skills. Internal peer equity is also examined to maintain balance within the organization. Additionally, current market conditions and overall organizational needs are crucial in shaping the final offer. Each aspect is thoughtfully reviewed before extending an offer, ensuring a comprehensive and equitable approach.
ReKlame Health is an equal opportunity employer. We celebrate diversity and are committed to creating a supportive and inclusive environment for all employees.
If you’re hungry for a challenge in 2025, love solving problems, and want to be a part of something transformational, we’d love to hear from you!
Learn more about us at
www.ReKlamehealth.com_*We never ask for money or sensitive personal information during the job application process. If you receive an email or message claiming to be from us that requests such information, please do not respond and report it as a scam._
How to Apply:
Apply through the official Startup Jobs application flow.
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