Medical Biller / Coder & Credentialing Specialist

Location: Tucson

Employment Type: Full-Time

Schedule: Monday – Friday

Our 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 Overview

The 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 Responsibilities

Medical Coding

Review provider documentation and assign accurate ICD-10, CPT, and HCPCS codes

Ensure coding complies with payer regulations and industry guidelines

Identify documentation gaps and communicate with providers when clarification is required

Support coding compliance and documentation improvement

Claims & Billing

Prepare and submit electronic claims through the practice management system

Monitor claim status and follow up on unpaid or denied claims

Investigate claim rejections and coordinate corrections with staff

Work with clearinghouses and insurance payers to resolve billing issues

Revenue Cycle Management

Monitor and manage accounts receivable

Track aging reports and follow up on outstanding balances

Investigate underpayments and payer discrepancies

Support efforts to improve clean claim rate and reduce days in A/R

Provider Credentialing & Enrollment

Manage provider credentialing and recredentialing with commercial and government payers

Maintain provider enrollment records and credentialing documentation

Track credentialing timelines and renewal deadlines

Coordinate payer enrollment applications and updates

Ensure provider information is accurately reflected in payer systems

Work with leadership and providers to ensure timely credentialing during onboarding

Compliance & Quality

Maintain compliance with billing regulations and payer policies

Support internal billing and coding audits

Ensure HIPAA compliance and protection of patient data

Reporting & Operational Support

Generate billing, collections, and credentialing status reports

Identify opportunities to improve billing workflows and revenue cycle performance

Collaborate with leadership to improve operational efficiency

Qualifications

Required

Minimum 3 years experience in medical billing, coding, or revenue cycle management

Experience with provider credentialing and payer enrollment

Strong knowledge of ICD-10, CPT, and HCPCS coding

Experience working with insurance payers and claim follow-up

Strong attention to detail and organizational skills

Preferred CPC, CCS, or equivalent coding certification

Experience in dermatology or outpatient specialty practices

Experience with Modernizing Medicine (ModMed EMA) or similar EMR systems

Knowledge of dermatology procedures, Mohs surgery billing, or cosmetic services

Key Competencies

Strong analytical and problem-solving abilities

Excellent attention to detail

Ability to manage multiple priorities and deadlines

Strong communication skills with clinical and administrative teams

Commitment to compliance and billing accuracy

What We Offer

Competitive compensation based on experience

Monday–Friday work schedule

Professional and collaborative work environment

Opportunity to support and improve revenue cycle operations within a growing healthcare organization