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Medical Coding & Billing Specialist

3 weeks, 1 day ago
United States
Full-time
Mid Level
Accountant
Operations
Apply Now
Imagine Pediatrics

Imagine Pediatrics

Imagine Pediatrics provides virtual healthcare services for children with complex medical conditions, offering a multidisciplinary team of pediatricians, nurses, and therapists who collaborate with existing healthcare providers to ensure comprehensive ...

Health Care Providers & Services
11-50
Founded 2022
View All Jobs 6

Description

  • Submit clean, timely claims with accurate CPT, HCPCS, ICD-10, and modifier coding.
  • Track, resolve, and resubmit denials, rejections, and underpayments.
  • Validate eligibility, authorization, and proper billing pathways for patient encounters.
  • Ensure correct use of telehealth, SDOH, and preventive care codes.
  • Review provider documentation and assign accurate ICD-10-CM, CPT, and HEDIS/quality reporting codes.
  • Identify and escalate incomplete documentation or coding gaps and issue coding queries when needed.
  • Educate providers, under the Coding Manager’s guidance, to improve documentation quality.
  • Support implementation and testing of new documentation macros and encounter note templates.
  • Maintain and update the internal billing rules matrix across payer, state, provider type, and modifiers.
  • Collaborate with Data & Analytics, Revenue Cycle, Clinical Ops, credentialing, partner success, and payer representatives to improve compliance and workflow performance.

Requirements

  • AAPC Certified Professional Coder (CPC) required.
  • 3–5 years of experience in physician billing and coding, with pediatrics preferred.
  • Proficiency with Athena EMR and Microsoft Excel.
  • Deep understanding of CPT, HCPCS, ICD-10, HEDIS, and Medicaid/commercial payer billing.
  • Experience with telehealth billing, value-based care, capitation models, and quality measures is a plus.
  • Ability to adapt quickly in a fast-changing startup environment.
  • Strong cross-functional communication and collaboration skills.
  • Commitment to supporting children with special health care needs and contributing to a diverse, values-driven culture.

Benefits

  • Salary range of $55,000–$65,000.
  • Annual bonus incentive.
  • Eligibility to participate in an employee equity purchase program, as applicable.
  • Competitive medical, dental, and vision insurance.
  • Healthcare and Dependent Care FSA, plus a company-funded HSA.
  • 401(k) with 4% match, vested 100% from day one.
  • Employer-paid short- and long-term disability insurance.
  • Life insurance at 1x annual salary.
  • 20 days PTO, 10 company holidays, and 2 floating holidays.
  • Paid new parent leave.
  • Additional benefits to be detailed in the offer.

Interested in this position?

Apply directly on the company website

Apply Now

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