Medical Biller / Coder & Credentialing Specialist

Location: Tucson Employment Type: Full-TimeSchedule: Monday – FridayOur multi-location healthcare organization is seeking a highly organized professional who understands both medical billing/coding and provider credentialing and can support operational improvements within the revenue cycle.Position OverviewThe Medical Biller / Coder & Credentialing Specialist will manage key functions of the revenue cycle including coding accuracy, claims processing, payer credentialing, denial management, and provider enrollment.This role works closely with providers, leadership, and clinical teams to ensure accurate billing, compliance with payer requirements, and efficient reimbursement processes.Key ResponsibilitiesMedical CodingReview provider documentation and assign accurate ICD-10, CPT, and HCPCS codesEnsure coding complies with payer regulations and industry guidelinesIdentify documentation gaps and communicate with providers when clarification is requiredSupport coding compliance and documentation improvementClaims & BillingPrepare and submit electronic claims through the practice management systemMonitor claim status and follow up on unpaid or denied claimsInvestigate claim rejections and coordinate corrections with staffWork with clearinghouses and insurance payers to resolve billing issuesRevenue Cycle ManagementMonitor and manage accounts receivableTrack aging reports and follow up on outstanding balancesInvestigate underpayments and payer discrepanciesSupport efforts to improve clean claim rate and reduce days in A/RProvider Credentialing & EnrollmentManage provider credentialing and recredentialing with commercial and government payersMaintain provider enrollment records and credentialing documentationTrack credentialing timelines and renewal deadlinesCoordinate payer enrollment applications and updatesEnsure provider information is accurately reflected in payer systemsWork with leadership and providers to ensure timely credentialing during onboardingCompliance & QualityMaintain compliance with billing regulations and payer policiesSupport internal billing and coding auditsEnsure HIPAA compliance and protection of patient dataReporting & Operational SupportGenerate billing, collections, and credentialing status reportsIdentify opportunities to improve billing workflows and revenue cycle performanceCollaborate with leadership to improve operational efficiencyQualificationsRequiredMinimum 3 years experience in medical billing, coding, or revenue cycle managementExperience with provider credentialing and payer enrollmentStrong knowledge of ICD-10, CPT, and HCPCS codingExperience working with insurance payers and claim follow-upStrong attention to detail and organizational skillsPreferred CPC, CCS, or equivalent coding certificationExperience in dermatology or outpatient specialty practicesExperience with Modernizing Medicine (ModMed EMA) or similar EMR systemsKnowledge of dermatology procedures, Mohs surgery billing, or cosmetic servicesKey CompetenciesStrong analytical and problem-solving abilitiesExcellent attention to detailAbility to manage multiple priorities and deadlinesStrong communication skills with clinical and administrative teamsCommitment to compliance and billing accuracyWhat We OfferCompetitive compensation based on experienceMonday–Friday work scheduleProfessional and collaborative work environmentOpportunity to support and improve revenue cycle operations within a growing healthcare organization

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