Pediatric Medical Biller - End-to-End Billing Lead

AAPC; Allen (TX); On-site; USD 37,000 - 54,000; Full time

Job summary

AAPC is seeking an experienced Medical Biller for an on-site pediatric practice in the United States. The ideal candidate will manage the full medical billing cycle, emphasize reviewing, reworking, and resolving denied claims, and use Office Practicum (OP) to manage claims, payments, and reporting.

Responsibilities include denial management, coding questions resolution, appeals, and proactive AR follow-up. The role requires HIPAA compliance, attention to detail, and independence in handling

Qualifications

• Previous experience in medical billing, preferably in a physician or pediatric practice.
• Strong understanding of the full medical billing cycle.
• Demonstrated experience with insurance claims, denials, appeals, payment posting, EOBs/ERAs, and accounts receivable.
• Proficiency with Office Practicum (OP) strongly preferred.
• Experience communicating with insurance companies to resolve claim and payment issues.
• Strong attention to detail and accuracy.
• Excellent organizational and follow-through skills.
• Ability to work independently and manage multiple priorities.
• Strong written and verbal communication skills.
• Knowledge of HIPAA and patient confidentiality requirements.

Responsibilities

• Manage the medical billing process from charge entry and claim submission through payment and account resolution.
• Review, research, and rework denied, rejected, and unpaid insurance claims.
• Identify the cause of claim denials and take appropriate corrective action.
• Correct and resubmit claims, addressing coding, eligibility, demographic, authorization, and documentation issues.
• Follow up with insurance companies regarding outstanding claims, denials, underpayments, and payment discrepancies.
• Submit appeals and supporting documentation when appropriate.
• Monitor accounts receivable and proactively follow up on outstanding balances.
• Utilize Office Practicum to manage patient accounts, claims, insurance information, billing history, payments, and reports.
• Review EOBs and ERAs and ensure payments are accurately posted and applied.
• Identify and resolve billing discrepancies and patient account issues.
• Verify insurance eligibility and benefits when necessary.
• Maintain accurate patient demographics and insurance information.
• Work with providers and clinical/administrative staff to resolve issues that may prevent timely claim payment.
• Monitor claims for timely filing requirements and ensure outstanding claims are addressed promptly.
• Identify recurring billing and denial trends and communicate opportunities for improvement to management.
• Assist with patient billing questions and account inquiries as needed.
• Maintain accurate billing documentation and records.
• Ensure all billing practices comply with HIPAA and applicable payer requirements.
• Take on additional billing responsibilities as appropriate, with the opportunity to assume primary responsibility for the practice's overall billing operations.

Skills

Medical billing

Office Practicum

HIPAA knowledge

Denials management

Attention to detail

Insurance liaison

Tools

Office Practicum (OP)

Job description

AAPC is seeking an experienced Medical Biller for an on-site pediatric practice in the United States. The ideal candidate will manage the full medical billing cycle, emphasize reviewing, reworking, and resolving denied claims, and use Office Practicum (OP) to manage claims, payments, and reporting.

Responsibilities include denial management, coding questions resolution, appeals, and proactive AR follow-up. The role requires HIPAA compliance, attention to detail, and independence in handling