Pediatric Coding & Billing Specialist — CPC Certified

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

Benefits offered by this job

Medical, dental, vision insurance

401(k) with 4% match

HSA eligible

PTO 20 days + 10 holidays + 2 floating

Job summary

Imagine Pediatrics is actively hiring a Billing & Claims professional in the United States to optimize coding and documentation while ensuring compliance across payer requirements. You will submit clean claims, track denials, and validate eligibility for patient encounters, leveraging telehealthbilling know-how and CPT/ICD-10 guidance.

The role requires CPC certification and 3–5 years of pediatrics billing experience, with proficiency in Athena EMR and Excel.

Qualifications

• AAPC CPC certification 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 and value-based care beneficial

Responsibilities

• Submit clean, timely claims with CPT, HCPCS, ICD-10 codes, and modifiers.
• Track denials, rejections, and underpayments with follow-up and resubmission.
• Validate eligibility, authorization, and proper billing pathways for all patient encounters.
• Ensure accurate telehealth, SDOH, and preventive care codes.
• Coordinate with credentialing, partner success, and payer reps to ensure claims compliance.
• Perform other duties as assigned.
• Review provider documentation and assign accurate codes per ICD-10-CM, CPT, and HEDIS/quality reporting guidelines.
• Identify and elevate incomplete documentation or coding gaps; issue coding queries as needed.
• Educate providers under the guidance of the Coding Manager to drive documentation improvement.
• Support implementation and testing of new documentation macros and encounter note templates.

Skills

CPC coding

Pediatric billing

Telehealth billing

Excel proficiency

Attention to detail

Tools

Athena EMR

Microsoft Excel

Job description

Imagine Pediatrics is actively hiring a Billing & Claims professional in the United States to optimize coding and documentation while ensuring compliance across payer requirements. You will submit clean claims, track denials, and validate eligibility for patient encounters, leveraging telehealthbilling know-how and CPT/ICD-10 guidance.

The role requires CPC certification and 3–5 years of pediatrics billing experience, with proficiency in Athena EMR and Excel.