Medical Coding and Billing Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Submit precise and timely claims utilizing accurate CPT, HCPCS, ICD-10 codes, and modifiers.

• Monitor and address denials, rejections, and underpayments with the necessary follow-up and resubmission.

• Confirm eligibility, authorization, and correct billing pathways for all patient interactions.

• Ensure the proper application of telehealth, SDOH, and preventive care coding.

• Collaborate with credentialing, partner success, and payer representatives to maintain claims compliance.

• Review provider documentation and assign the correct codes according to ICD-10-CM, CPT, and HEDIS/quality reporting standards.

• Identify and escalate any incomplete documentation or coding discrepancies; issue coding queries as required.

• Educate providers, under the supervision of the Coding Manager, to promote improvements in documentation.

⛳️ Requirements

• AAPC Certified Professional Coder (CPC) certification is mandatory.

• 3–5 years of experience in physician billing and coding, with a preference for pediatrics.

• Proficient in Athena EMR and Microsoft Excel.

• Extensive knowledge of CPT, HCPCS, ICD-10, HEDIS, and Medicaid/commercial payers.

• Familiarity with telehealth billing, value-based care, capitation models, and quality measures is a plus.

🏝️ Benefits

• Competitive medical, dental, and vision insurance.

• Healthcare and Dependent Care FSA; Company-funded HSA.

• 401(k) with a 4% match, fully vested from day one.

• Employer-covered short and long-term disability.

• Life insurance equivalent to 1x annual salary.

• 20 days of PTO, plus 10 Company Holidays and 2 Floating Holidays.

• Paid leave for new parents.

• Additional benefits will be outlined in the offer.