Patient-Centered Medical Home | South Carolina
Medical Billing & Coding Specialist
Full-Time | Hybrid (In-Office + Remote) | Competitive Salary DOE
We are seeking an experienced, certified billing and coding professional to join our team. This is not just a clinic, it is a mission.
We are looking for a serious professional who is dependable, hardworking, and passionate about people and their health. The right candidate will be a self-sufficient, team player who takes initiative, abides by company policies, and contributes to a culture of revenue integrity, clinical excellence, and patient advocacy.
If you thrive in a fast-paced environment, value teamwork, take pride in clean claims and accurate coding, and are motivated to make a meaningful impact in value-based healthcare, then we want to hear from you.
ABOUT INTERNAL MEDICINE
Internal Medicine practice is a Patient-Centered Medical Home (PCMH) located in Simpsonville, South Carolina providing primary care and internal medicine services. We participate in value-based care arrangements including Aledade ACO (Medicare Shared Savings Program) and a Humana/Blue Medicare ACO. Our practice delivers comprehensive primary care supported by embedded service lines including Chronic Care Management (CCM), Remote Patient Monitoring (RPM), Remote Therapeutic Monitoring (RTM), Sleep Medicine, Clinical Research, Retinal Scanning, and Vaccine Programs. At our Internal Medicine practice, we believe in delivering compassionate care. Our team of board-certified physicians and healthcare professionals is here to guide you on your healthcare journey.
As we bring our billing and coding function fully in-house, we are seeking a specialist who understands that accurate documentation and coding is not administrative overhead, it is the financial backbone of the care we deliver.
POSITION OVERVIEW
Title
Medical Billing & Coding Specialist
Type
Full-Time
Schedule
Hybrid — In-office required; remote days available after onboarding
Reports To
Office manager
EMR
Athena Health (training available for the right candidate)
Salary
$55,000 – $65,000 DOE + benefits
KEY RESPONSIBILITIES
- Manage full-cycle medical billing in Athena Health including charge entry, claim submission, missing slips, claims on hold buckets, payment posting, unpostables, credit balances, billing correspondence and reconciliations
- Apply accurate ICD-10 coding with HCC/RAF specificity for Medicare Advantage and ACO patient populations
- Conduct denial management, payer follow-up, and appeals to minimize revenue leakage
- Ensure E&M coding accuracy and 99211 visit compliance across all service lines
- Support billing workflows for CCM, RPM, RTM, Retinal Scan, and Vaccine programs
- Monitor and report on key revenue cycle metrics monthly to the Manager
- Identify underpayment and downcoding patterns and flag payer discrepancies for corrective action
- Collaborate with clinical staff to improve documentation specificity and chronic condition capture
- Stay current on CMS HCC model updates (V28 fully implemented in 2026), payer policy changes, and coding guideline revisions
- Maintain compliance with HIPAA, CMS guidelines, and practice billing standards
- Collaboration with front desk and intake teams to optimize patient data and accuracy of demographic entry and coordination of benefits
REQUIRED QUALIFICATIONS
- Minimum 3–5 years of experience in medical billing and coding in a physician practice or outpatient setting
- Active certification required: CPC (AAPC), CCS-P (AHIMA), or equivalent
- Demonstrated proficiency in ICD-10-CM coding and CPT/HCPCS code sets
- Experience with E&M coding guidelines and documentation requirements
- Strong understanding of claim lifecycle: submission, denial, appeal, and reimbursement
- Ability to work independently with minimal supervision in a hybrid work environment
- High attention to detail and commitment to compliance and coding accuracy
PREFERRED QUALIFICATIONS
- Athena Health EMR experience strongly preferred
- HCC/RAF coding experience for Medicare Advantage or ACO populations
- Familiarity with value-based care billing (MSSP, Medicare Advantage, capitation)
- CRC certification (Certified Risk Adjustment Coder — AAPC) is a significant advantage
- Experience with CCM, RPM, or RTM billing (CPT 99490–99491, 99453–99458)
- Background in internal medicine or primary care practice billing
- Knowledge of Annual Wellness Visit (AWV) and preventive care billing
WHO YOU ARE
- You take ownership of your work and don’t wait to be told what needs to be done
- You understand that every accurate code and clean claim directly funds the care our patients receive
- You can work independently from home when needed without losing focus or accountability
- You communicate proactively when you see a problem and bring solutions, not just issues
- You are organized, deadline-driven, and thrive with structured workflows
- You align with a team culture built on integrity, mission, and excellence
- You are honest, ethical, and believe in transparent communication and collaboration
ACCEPTED CERTIFICATIONS
· Preferred:
o CPC: Certified Professional Coder (AAPC)
· Highly Valued:
o CRC: Certified Risk Adjustment Coder (AAPC)
o CCS-P: Certified Coding Specialist–Physician-based (AHIMA)
o CPB: Certified Professional Biller (AAPC)
How to Apply
Submit your resume, active certification documentation, a brief cover letter explaining your billing and coding background and why you want to work at this Internal Medicine. Provide a minimum of three references and tell us, what value-based care or HCC coding experience do you bring — and why does our mission resonate with you?
Internal Medicine | South Carolina
Equal Opportunity Employer
Pay: $55,000.00 - $65,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Paid time off
- Vision insurance
Work Location: Hybrid remote in Simpsonville, SC 29681
