Hybrid Medical Billing & Coding Specialist (CPC)

Imagine Pediatrics; United States; Hybrid; USD 55,000 - 65,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

HSA

401k with match

Disability Insurance

Life Insurance

PTO & Holidays

Parental Leave

Job summary

Imagine Pediatrics is seeking a Medical Billing & Coding Specialist in a hybrid role that blends coding precision with billing strategy to ensure timely and accurate claims submission, compliance, and payment. You will collaborate with providers, the data team, and partner operations to streamline workflows and reduce denials.

You will submit clean claims with CPT/HCPCS/ICD-10, track denials, validate eligibility, and ensure correct telehealth and preventive care coding.

Qualifications

• CPC Certification through AAPC required.
• 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, value-based care, capitation models, and quality measures a plus.

Responsibilities

• 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

Skills

Billing accuracy

Pediatrics experience

Communication skills

Healthcare compliance

Education

AAPC CPC Certification

Tools

Athena EMR

Microsoft Excel

Job description

Imagine Pediatrics is seeking a Medical Billing & Coding Specialist in a hybrid role that blends coding precision with billing strategy to ensure timely and accurate claims submission, compliance, and payment. You will collaborate with providers, the data team, and partner operations to streamline workflows and reduce denials.

You will submit clean claims with CPT/HCPCS/ICD-10, track denials, validate eligibility, and ensure correct telehealth and preventive care coding.