Coding and Billing Specialist

Imagine Pediatrics

Coding and Billing Specialist for pediatric medical group focused on enhancing care for children with special health needs. Collaborating to ensure compliance and accurate claims submission.

Posted 4/30/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $55,000 - $65,000 per yearWebsite

About the role

Key responsibilities & impact

Submit clean, timely claims with accurate CPT, HCPCS, ICD-10 codes, and modifiers.
Track and resolve denials, rejections, and underpayments with appropriate follow-up and resubmission.
Validate eligibility, authorization, and proper billing pathways for all patient encounters.
Ensure accurate use of 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 escalate 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.
Maintain and contribute to the internal billing rules matrix (payer, state, provider type, modifiers).
Collaborate with the Data & Analytics team to track claim trends, documentation compliance, and A/R performance.
Partner with Revenue Cycle and Clinical Ops to align workflows with payer requirements and business goals.
Support provider training, macro updates, and compliance education efforts.

Requirements

What you’ll need

Certified Professional Coder (CPC) (Preferred)
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, capitation models, and quality measures a plus

Benefits

Comp & perks

Competitive medical, dental, and vision insurance
Healthcare and Dependent Care FSA; Company-funded HSA
401(k) with 4% match, vested 100% from day one
Employer-paid short and long-term disability
Life insurance at 1x annual salary
20 days PTO + 10 Company Holidays & 2 Floating Holidays
Paid new parent leave
Additional benefits to be detailed in offer

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

CPT codingHCPCS codingICD-10 codingHEDIS reportingtelehealth billingdocumentation improvementclaims submissionbilling pathwayscoding queriesdata analysis

Soft Skills

communicationcollaborationproblem-solvingattention to detaileducational skillsorganizational skillsfollow-uptrainingescalationadaptability

Certifications

Certified Professional Coder (CPC)