Pediatric Coding Specialist: Claims & Compliance Pro

Pediatrica Health Group; Miami (FL); On-site; USD 52,000 - 70,000; Full time

Job summary

Pediatrica Health Group is seeking a skilled Medical Coder with CPC-P certification to join our pediatric care team in Miami. You will review clinical documentation, assign ICD-10, CPT, and HCPCS codes, and support accurate claims submission.

The role requires at least two years of pediatric coding experience, proficiency with EMR systems and MS Office, and strict HIPAA compliance. You will collaborate with clinicians and billing staff to maximize accurate reimbursement.

Qualifications

• High school diploma or equivalent.
• CPC-P certification is required.
• Minimum of two years of medical coding experience, preferably in a pediatric healthcare setting.
• In-depth knowledge of pediatric-specific coding, medical terminology, and insurance guidelines.
• Proficient in using coding software, EMR systems, and Microsoft Office applications.
• Excellent attention to detail and organizational skills.
• Strong verbal and written communication skills.
• Commitment to maintaining patient confidentiality and adhering to HIPAA regulations.

Responsibilities

• Review clinical documentation and assign appropriate ICD-10, CPT, and HCPCS codes for pediatric diagnoses and procedures.
• Ensure coding compliance with federal regulations, payer policies, and organizational standards.
• Query providers when necessary for additional information or clarification to ensure accurate coding.
• Assist in the education of providers and staff regarding coding updates, documentation improvement, and regulatory requirements.
• Audit coded data for accuracy and provide feedback to clinical staff as needed.
• Submit clean claims for reimbursement in a timely manner and assist with denial management processes related to coding issues.
• Stay current with changes in coding guidelines, payer requirements, and pediatric coding best practices.
• Support revenue cycle management by ensuring optimal coding accuracy and maximizing reimbursement.

Skills

Pediatric coding

Medical coding

EMR systems

Microsoft Office

Attention to detail

Verbal and written communication

HIPAA compliance

Education

High school diploma or equivalent

CPC-P Certification

Tools

EMR systems

Microsoft Office

Job description

Pediatrica Health Group is seeking a skilled Medical Coder with CPC-P certification to join our pediatric care team in Miami. You will review clinical documentation, assign ICD-10, CPT, and HCPCS codes, and support accurate claims submission.

The role requires at least two years of pediatric coding experience, proficiency with EMR systems and MS Office, and strict HIPAA compliance. You will collaborate with clinicians and billing staff to maximize accurate reimbursement.