Coding and Billing Specialist

🕒 April 30

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Imagine Pediatrics

WebsiteLinkedInAll Job Openings

51 - 200 employees

🧘 Wellness

👥 B2C

Healthcare • Wellness • B2C

Imagine Pediatrics is a healthcare provider focused on delivering specialized pediatric care. The company is dedicated to improving children's health through personalized medical attention, preventive care, and effective treatment options. With a team of experienced professionals, Imagine Pediatrics aims to create a supportive and welcoming environment for children and their families, emphasizing the importance of a healthy start for all individuals.

📋 Description

• 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.

🎯 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