
Medical Coder
- Kenya
- Permanent
- Full-time
- Lead and manage the revenue cycle team, including billing, coding, and collections staff
- Monitor and improve billing accuracy, referrals/prior authorizations, claim submission, and denial prevention/management
- Develop and implement strategies to accelerate revenue collection (including precollections) and reduce AR days
- Collaborate with clinical and administrative departments to streamline workflows, including office visits, testing procedures, and DME
- Analyze financial reports and present revenue cycle performance to leadership
- Negotiate with payers on reimbursement issues, fee schedules, and resolution of escalated claims
- Train and mentor staff on billing software, coding updates, and regulatory changes
- Conduct internal audits to ensure coding accuracy and billing integrity
- Maintain up-to-date knowledge of medical coding, payer policies, and industry trends
- 5+ years of experience in outpatient clinic medical billing and revenue cycle management
- Strong knowledge of Athenahealth EMR/EHR systems, billing software, and reports
- Certification in medical coding (e.g., CPC, CCS) preferred
- Excellent leadership, analytical, and communication skills
- Proven ability to manage teams and drive performance metrics
- Claims Management: Transmit claims through the EHR, scrub for accuracy, and ensure timely submission.
- Remittance Posting: Apply remits electronically; process both electronic and paper Explanation of Benefits (EOBs).
- Denials & Corrected Claims: Work corrected claims, re-submit as needed, and manage claim denials through appeals and follow-ups.
- Payment Tracking: Post payments to client accounts, track balances owed, and reconcile discrepancies.
- Reconciliation: Reconcile all payments received (electronic and paper) against bank deposits and internal records.
- Reporting: Generate company productivity reports, including revenue per therapist and other KPIs.
- Compliance & Accuracy: Maintain strict adherence to HIPAA, payer requirements, and billing standards.
- Minimum 3+ years of experience in medical billing, coding, and revenue cycle management.
- Medical coder licensed
- Strong knowledge of EHR and billing workflows (experience with Athena or similar systems preferred).
- Proficient in processing electronic and paper claims/EOBs.
- Hands-on experience with denial management, corrected claims, and appeals.
- Strong Excel/reporting skills (pivot tables, formulas, productivity metrics).
- Excellent organizational skills and high attention to detail.
- Strong communication skills for provider, payer, and team collaboration.
- Ability to work independently and meet deadlines in a fast-paced environment.