Medical Billing & Coding Specialist

Overview

We are a well-established, patient-focused pediatric practice committed to providing exceptional care to children and families in our community. We are seeking an experienced Medical Coding & Billing Specialist who is detail-oriented, proactive, and passionate about maximizing revenue cycle performance while maintaining accurate coding and compliance.

Position Summary

The Medical Coding & Billing Specialist will be responsible for all aspects of medical billing, coding, and accounts receivable management. The ideal candidate has experience working in a pediatric practice, is proficient with eClinicalWorks (eCW), and has a strong understanding of insurance claim processing, payment posting, denial management, and coding compliance.

We are also looking for someone who is excited about the future of healthcare technology. Experience with AI-assisted coding or revenue cycle management (RCM) software is highly preferred.

Responsibilities

• Accurately code pediatric office visits and procedures using ICD-10-CM, CPT, and HCPCS coding guidelines.
• Review provider documentation to ensure coding accuracy and compliance.
• Submit and monitor insurance claims electronically.
• Follow up on unpaid, denied, and underpaid claims.
• Manage accounts receivable (A/R) and work aging reports to maximize collections.
• Research and resolve claim denials and payment discrepancies.
• Process insurance appeals when necessary.
• Post insurance and patient payments accurately.
• Verify payer guidelines and stay current with coding and reimbursement changes.
• Collaborate with providers and clinical staff to improve documentation and coding accuracy.
• Generate and analyze billing and A/R reports.
• Assist with payer credentialing or enrollment issues as needed.
• Help implement new technologies and workflows that improve billing efficiency.