Certified Medical Coder/Medical Biller - Idaho

Benefits:

• 401(k) matching
• Competitive salary



Role Summary

The Billing Lead oversees EverCare’s billing operations, ensuring timely, accurate, and compliant revenue capture across multiple states and from multiple payers. This role demands both hands-on technical expertise and leadership: someone who understands the inner workings of multiple EHRs/billing systems, can drive process improvement, optimize reimbursement strategies, ensure audit readiness, and build a high-performing billing team that supports the mobile mental health care model inside long-term care facilities.

Key Accountabilities

Team Leadership & Development

• Lead, manage, and hold accountable the billing team - including credentialing, claims specialists, and billing professionals - to ensure accuracy, efficiency, and compliance in all billing operations while driving consistent cash flow and organizational success.
• Hire, onboard, train, mentor, and evaluate team members.
• Build a culture of continuous improvement, accountability, and collaboration.

Claims & Insurance Management

• Oversee timely and accurate preparation, submission, and follow-up on claims for 13+ payers across multiple states.
• Ensure insurance verification processes are reliable and efficient.
• Apply payer-specific knowledge and coding sequence strategies to maximize allowable reimbursements while staying fully compliant.
• Manage and monitor payer portals for claim status, rejections, and communication.

Credentialing & Provider Enrollment

• Ensure providers are properly credentialed/enrolled with payers; monitor renewals to avoid lapses.
• Liaise with payers and networks to manage enrollments, re-enrollments, and new payer additions.

Coding & Documentation Oversight

• Ensure proper CPT/ICD coding and documentation to support claims.
• Optimize reimbursement through accurate code ordering, modifier usage, and alignment with payer rules.

Revenue Cycle Optimization

• Measure, monitor, and improve revenue cycle KPIs (A/R days, denial rate, clean claim rate, etc.).
• Track, reconcile, and manage accounts receivable to minimize aging and improve collections.
• Continuously refine billing practices to capture the maximum legitimate revenue possible.

Technical & System Management

• Manage and evaluate multiple EHR/billing software tools.
• Lead system migrations/upgrades; ensure data integrity and minimal disruption.
• Utilize reporting tools and dashboards to provide actionable insights for leadership.

Compliance & Audit Readiness

• Stay current with payer regulation changes, state Medicaid/Medicare rules, and coding updates.
• Maintain compliant billing practices; ensure documentation satisfies audit requirements.
• Conduct regular internal audits and prepare for external reviews as needed.

Reporting & Financial Oversight

• Provide regular revenue and billing performance reports to the Finance Lead.
• Forecast revenue, including impacts of denials, rate changes, or payer delays.
• Manage billing department budget and vendor relationships.

Policy, Procedures & Documentation

• Write, maintain, and update Standard Operating Procedures (SOPs) for all billing processes.
• Ensure staff adhere to procedures and perform internal process audits.

Stakeholder Collaboration

• Work closely with clinical and operations teams to ensure documentation supports billing.
• Engage payer representatives for escalated or complex issues.
• Coordinate with IT for system integration, data extraction, and vendor management.

Qualifications

• Certified Professional Biller (CPB), Certified Professional Coder (CPC), or equivalent strongly preferred.
• Minimum 5–7 years of experience in medical billing/revenue cycle, including leadership/supervisory responsibilities.
• Experience with multiple EHR/billing systems, including billing migrations.
• Proven success leading a billing team and managing change.
• Strong understanding of mental/behavioral health billing; care management billing highly desirable.
• Long-term care facility billing experience a plus.
• Multi-state billing knowledge (currently Oregon and Idaho; expansion expected).
• Tech-forward mindset with comfort in adopting new tools, reporting systems, and data dashboards.
• Excellent analytical, problem-solving, and communication skills.
• Must be familiar with insurers in Idaho and Oregon.

Success Metrics / KPIs

• A/R aging maintained under target threshold.
• Denial rate reduced year-over-year.
• Clean claim submission rate at or above target.
• Credentialing completed on time, with no lapses.
• Revenue collections consistently align with allowable payer reimbursements.
• Forecasted vs. actual revenue within acceptable variance.

Attributes / Fit

• Tech-forward and adaptable, eager to leverage tools and automation.
• Process-oriented and detail-driven.
• Thrives in a fast-growth EOS® company, balancing structure with adaptability.
• Strong ethics and compliance mindset.
• Clear and confident communicator across staff, leadership, and external partners.

Core Values Alignment

At EverCare, our team members live out these values every day:

• Help First: Give abundantly. Serve without expecting.
• Embrace Change: Stay flexible. Keep learning. Grow stronger. Enjoy the ride.
• Have Fun, Get Stuff Done: Bring joy. Get it done. Be yourself.
• Built on Trust, Kept by Loyalty: Do what you say. Build trust. Take ownership.
• Be Bold: Care deeply. Act wisely. Create together. Inspire change.

The Billing Lead is expected to model these values in every aspect of leadership and decision-making, ensuring the billing function not only performs at a high level but also reflects the culture we are committed to building.

This is a remote position.

Compensation: $65,000.00 - $75,000.00 per year