Billing & Coding Analyst

Career Opportunity: Billing & Coding Analyst

Reports to: Director of Revenue Cycle Management

Organization: The HealthCare Connection (THCC)

Location: Cincinnati, OH - Hybrid Position

About The HealthCare Connection:

Founded in 1967, The HealthCare Connection was Ohio’s first Federally Qualified Health Center (FQHC). Our mission is to provide quality and accessible primary healthcare services through community responsive approaches that address financial, geographic, and other barriers to care for residents of

northern Hamilton County and surrounding areas. THCC is proudly recognized as a Level 3 Patient Centered Medical Home (PCMH), the highest level of recognition attainable for quality care.

We boast two primary care locations and 6 school-based health centers providing quality value-based care for over 20,000 patients. We provide services in Primary Care, Infectious Disease, Substance Use, Integrated Behavioral Health, Dental Services, Women’s Health, and Pharmacy.

Benefits:

• Health Insurance and Rewards Program
• Dental, and Vision Insurance
• Free Life & Short-Term Disability Insurance
• 403(b) Retirement Plan with employer match
• Comprehensive Paid Time Off (PTO)
• 10 Paid Holidays

Position Overview:

The Billing & Coding Analyst is responsible for accurate coding, charge review, risk‑adjustment support, and claims coordination within an FQHC environment. This role facilitates communication and workflows with the third‑party billing company, ensures compliance with FQHC billing requirements, supports providers with documentation improvement, and participates in revenue cycle special projects.

Key Responsibilities:

• Collaborate with the third‑party billing company to resolve coding‑related denials, edits, and claim rejections.
• Assist in monitoring A/R trends, denial rates, and vendor performance metrics.
• Review charge data for completeness, accuracy, and compliance prior to submission.
• Support month‑end close activities including coding reconciliation and reporting.
• Participate in special projects such as workflow redesign, EHR template optimization, payer audits, and regulatory updates.
• Provide coding and documentation guidance to providers and clinical departments.
• Follow up on outstanding claims.
• Generate reports and respond to inquiries regarding entered data, including monitoring unsigned notes.
• Maintain patient accounts that have been sent to collections.
• Ensure adherence to HRSA, UDS, Medicaid/Medicare, HIPAA, and other regulatory requirements
• Perform coding review of encounters to ensure accurate CPT, HCPCS, and ICD‑10 coding in compliance with payer and FQHC rules.
• Ensure adjustments and refunds are processed and accounts are updated appropriately. Review and initiate refunds for overpayments identified by the third-party billing company by audits.
• Review aging reports and work with third-party billing company to reduce aging balances. Review patient balances with front desk staff so calls can be made to patients.

Qualifications:

• High school diploma required; associate degree in health information, billing, or related field preferred.
• Certified coder required (CPC, CCS, or equivalent).
• Experience or training in risk‑adjustment coding; CRC preferred or willingness to obtain within 12 months.
• Minimum 2 years of medical billing and coding experience; FQHC experience strongly preferred.
• Knowledge of CPT, HCPCS, ICD‑10, PPS/FQHC billing rules, Medicaid, Medicare, and commercial payer requirements.
• Strong communication skills, attention to detail, and ability to collaborate with clinical, administrative, and external teams.
• Proficiency with EHR and billing software systems.

Preferred Qualifications:

• Risk‑adjustment coding certification (CRC).
• Experience coordinating with external billing vendors.
• Experience with NextGen and EPIC.

Equal Employment Opportunity/Drug-Free Workplace:

The HealthCare Connection is focused on creating a community that promotes dignity and respect for employees, patients and other community members. THCC is an Equal Opportunity Employer and a Drug-Free Workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, military status or other characteristics protected by law and will not be discriminated against based on disability.

THCC will only employ those who are legally authorized to work in the United States. Any offer of employment is conditioned upon the successful completion of a background check and a drug screen.