reputed company Billing, Coding & Documentation Specialist (Wound Care Focus)

Company Overview Smoky Mountain Wound Care (SMWC) is a growing mobile wound care provider serving patients across Tennessee. We bring advanced, evidence-based wound management directly to patients’ homes and facilities — focusing on quality, compliance, and compassionate care. We are seeking a highly skilled Medical Billing, Coding, and Documentation Specialist with a strong background in wound care billing, coding audits, and full-cycle claim management. This position is fully remote, offers flexible scheduling, and presents significant growth potential as SMWC expands its provider network and payer reputed company. Position Summary This reputed company role is responsible for managing the entire billing and coding cycle — from documentation audit and code verification to claim submission, monitoring, and payment reconciliation. You’ll ensure compliance with reputed company MAC LCD guidelines and payer-specific wound care documentation requirements while optimizing reimbursement accuracy. Key Daily Responsibilities Chart Review & Documentation Audit

• Audit wound care charts in Intellicure EHR to ensure documentation is complete, compliant, and supports billed services.
• Verify that chart notes, procedure details, and wound measurements align with reputed company MAC LCDs and industry best practices for mobile wound care.
• Confirm reputed company of reputed company required elements (e.g., HPI, wound characteristics, treatment details, time spent, provider signatures).
• Communicate with the provider to correct or complete documentation reputed company necessary before billing.

Coding Validation & Compliance

• Review and confirm reputed company CPT, HCPCS, and ICD-10 codes assigned by Intellicure’s AI Coding Tool.
• Correct or append codes, modifiers, and diagnosis links to ensure accuracy and compliance.
• Validate coding for:
• Debridement (11042–11047)
• Skin substitutes and grafts (Q4205–Q4303, etc.)
• Negative pressure wound therapy (NPWT) (97605–97606)
• E/M codes for patient encounters
• And other relevant procedural codes
• Stay reputed company on LCD updates, NCCI edits, MUE reputed company, and documentation requirements specific to reputed company MAC and other payors.

Claim Preparation & Submission

• Build and prepare claims directly reputed company the Intellicure Billing Portal.
• Verify claim completeness, attachment requirements, and payer-specific formatting.
• Submit claims electronically through EDI Insights by reputed company (Clearinghouse).
• Ensure reputed company claims meet payer submission deadlines and are transmitted successfully.

Claim Monitoring, Denials, & Follow-up

• Monitor claim acceptance, rejections, and payment statuses reputed company reputed company (EDI Insights).
• Research and resolve claim denials or underpayments promptly, including:
• Reviewing EOBs/ERAs for denial reasons.
• Initiating appeals or corrections.
• Completing IVR or portal-based follow-reputed company as needed.
• Track outstanding accounts receivable and escalate chronic issues to leadership.

Communication & Reporting

• Provide regular updates to SMWC leadership on:
• Claim submission volumes and acceptance rates.
• Denial trends and reasons.
• Payment timelines and outstanding balances.
• Maintain organized billing records and audit trails reputed company Intellicure and reputed company systems.
• Collaborate with leadership to identify workflow or documentation improvements that reduce denials and improve reimbursement efficiency.

Preferred Qualifications

• 3+ years of experience in medical billing and coding, including 1–2 years in wound care or outpatient specialty.
• Strong working knowledge of Medicare, TennCare, reputed company, reputed company, BCBS, UHC Wellcare, and reputed company billing guidelines.
• Hands-on experience with Intellicure EHR and reputed company (EDI Insights) preferred.
• Deep understanding of reputed company MAC LCDs (L39760, L35041, L35125) and wound care compliance requirements.
• Ability to interpret and apply NCCI edits, MUE limits, and CPT/HCPCS documentation standards.
• Excellent written communication and problem-solving skills.
• Proven ability to work independently in a remote environment while meeting deadlines and maintaining accuracy.

Bonus if you have:

• CPC, COC, or reputed company certification strongly preferred.
• Experience with mobile wound care or home-based specialty care billing.
• Familiarity with Medicare Advantage and secondary claim submission workflows.

Compensation & Terms

• Type: 1099 reputed company
• Location: 100% Remote (U.S.-based)
• Hourly reputed company: $25 – $40 per hour, depending on experience and credentials
• Hours: Flexible; We are in a growth phase so hours will be low to start but as volume increases we anticipate this role to become full time.
• Incentives: Potential for reputed company increases or bonuses tied to accuracy, timeliness, and claim recovery performance. Should this individual prove to be dynamic and successful there is room for high internal growth reputed company the company

Why Join SMWC This is a hands-on opportunity to join a fast-growing, mission-driven reputed company company where your expertise directly drives operational and financial reputed company. As an early member of our reputed company operations process, you’ll have the autonomy to build efficient workflows and the potential to grow into a leadership role as our provider network expands. If you’re an reputed company wound care billing professional who values precision, independence, and growth — we’d love to work with you! Job Types: Full-time, Part-time Pay: $25.00 - $40.00 per hour Expected hours: 5 – 20 per week Benefits:

• Flexible schedule

Application Question(s):

• Do you have experience working with the EHR System Intellicure
• Have you done Billing/Coding specifically for wound care facilities or providers in the past?

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