Reimagining pediatric health care. Together.
Coding and Billing Specialist
Location
United States
Posted
57 days ago
Salary
$55K - $65K / year
Seniority
Senior
Job Description
Coding and Billing Specialist
Imagine Pediatrics
• Submit clean, timely claims with accurate CPT, HCPCS, ICD-10 codes, and modifiers. • Track and resolve denials, rejections, and underpayments with appropriate follow-up and resubmission. • Validate eligibility, authorization, and proper billing pathways for all patient encounters. • Ensure accurate use of telehealth, SDOH, and preventive care codes. • Coordinate with credentialing, partner success, and payer reps to ensure claims compliance. • Perform other duties as assigned. • Review provider documentation and assign accurate codes per ICD-10-CM, CPT, and HEDIS/quality reporting guidelines. • Identify and escalate incomplete documentation or coding gaps; issue coding queries as needed. • Educate providers under the guidance of the Coding Manager to drive documentation improvement. • Support implementation and testing of new documentation macros and encounter note templates. • Maintain and contribute to the internal billing rules matrix (payer, state, provider type, modifiers). • Collaborate with the Data & Analytics team to track claim trends, documentation compliance, and A/R performance. • Partner with Revenue Cycle and Clinical Ops to align workflows with payer requirements and business goals. • Support provider training, macro updates, and compliance education efforts.
Job Requirements
- Certified Professional Coder (CPC) (Preferred)
- 3–5 years' experience in physician billing and coding (pediatrics preferred)
- Proficiency with Athena EMR and Microsoft Excel
- Deep understanding of CPT, HCPCS, ICD-10, HEDIS, and Medicaid/commercial payers
- Experience with telehealth billing, capitation models, and quality measures a plus
Benefits
- Competitive medical, dental, and vision insurance
- Healthcare and Dependent Care FSA; Company-funded HSA
- 401(k) with 4% match, vested 100% from day one
- Employer-paid short and long-term disability
- Life insurance at 1x annual salary
- 20 days PTO + 10 Company Holidays & 2 Floating Holidays
- Paid new parent leave
- Additional benefits to be detailed in offer
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