Medical Billing & Coding Specialist: Claims & Reimbursement Pro

Lake Country Pediatrics; Town of Oconomowoc (WI); On-site; USD 40,000 - 65,000; Full time

Job summary

Lake Country Pediatrics is seeking a Billing & Coding Specialist to manage daily billing operations within a pediatric healthcare setting. You will code with ICD-10, CPT, and DRG, submit claims, and follow up on denials to improve revenue cycle performance.

You will maintain accurate medical records, collaborate with providers to resolve documentation gaps, and stay compliant with HIPAA and Medicare/Medicaid rules. Expertise in EPIC and EMR/EHR systems is preferred.

Qualifications

• High School diploma or equivalent; Associate or Bachelor’s degree in Health Administration, Finance, Accounting, or related field preferred.
• 2+ years of experience in medical billing or healthcare revenue cycle preferred.
• Proficiency with billing software (e.g. EPIC), Microsoft Office (Excel, Word) and billing/accounting systems.
• Skilled or experience verifying insurance eligibility in online portals (UHC, Availity, Medicaid, etc.)

Responsibilities

• Review medical records and assign ICD-10, CPT, and DRG codes for billing.
• Prepare and submit claims to insurance companies using EMR/EHR systems.
• Follow up on unpaid or denied claims and pursue collections.
• Maintain detailed medical records including coding decisions and billing transactions.
• Collaborate with providers to clarify documentation discrepancies.
• Ensure compliance with HIPAA, Medicare/Medicaid requirements.
• Reconcile billing accounts and report metrics to management.
• Respond to billing inquiries via phone and email.

Skills

Strong communication

Attention to detail

Multi-tasking

Team collaboration

Understanding of billing regulations

Education

CPB/CMRS/CCS certifications

Associate or Bachelor’s degree in Health Admin/Finance/Accounting

Tools

EPIC

EMR/EHR systems

Billing software

Microsoft Excel

Job description

Lake Country Pediatrics is seeking a Billing & Coding Specialist to manage daily billing operations within a pediatric healthcare setting. You will code with ICD-10, CPT, and DRG, submit claims, and follow up on denials to improve revenue cycle performance.

You will maintain accurate medical records, collaborate with providers to resolve documentation gaps, and stay compliant with HIPAA and Medicare/Medicaid rules. Expertise in EPIC and EMR/EHR systems is preferred.