Who We Are
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs. We deliver 24/7 virtual-first and in-home medical, behavioral, and social care, working alongside families, providers, and health plans to break down barriers to quality care.
Role Summary
This is a hybrid billing and coding role focused on accurate claim submission, compliance, documentation improvement, and denial reduction. You will work closely with providers, the data team, and partner operations to streamline workflows and support revenue cycle performance.
What You'll Do
Billing & Claims Execution
- Submit clean, timely claims with accurate CPT, HCPCS, ICD-10 codes, and modifiers.
- Track and resolve denials, rejections, and underpayments with follow-up and resubmission.
- Validate eligibility, authorization, and proper billing pathways for patient encounters.
- Ensure accurate use of telehealth, SDOH, and preventive care codes.
- Coordinate with credentialing, partner success, and payer representatives to ensure claims compliance.
- Perform other duties as assigned.
Coding & Documentation Optimization
- 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 improve documentation.
- Support implementation and testing of new documentation macros and encounter note templates.
Cross-Team Workflow Ownership
- Maintain and contribute to the internal billing rules matrix for payer, state, provider type, and modifiers.
- Collaborate with the Data & Analytics team to track claim trends, documentation compliance, and A/R performance.
- Partner with Revenue Cycle and Clinical Operations to align workflows with payer requirements and business goals.
- Support provider training, macro updates, and compliance education efforts.
Requirements and Qualifications
- CPC certification through AAPC is required.
- 3-5 years of experience in physician billing and coding, preferably pediatrics.
- Proficiency with Athena EMR and Microsoft Excel.
- Strong understanding of CPT, HCPCS, ICD-10, HEDIS, and Medicaid/commercial payer workflows.
- Experience with telehealth billing, value-based care, capitation models, and quality measures is a plus.
Benefits and Perks
- Salary range of $55,000-$65,000 per year
- Annual bonus incentive
- 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, and 2 floating holidays
- Paid new parent leave
- Eligibility to participate in an employee equity purchase program, as applicable
Location
Texas, US
Employment Type
Full-time
Experience Level
Intermediate Level
Salary Range
$55,000 - $65,000
Remote work allowed
No
Posted
1 month ago