Overview

Join our team as a certified Medical Coding & Revenue Cycle Specialist dedicated to managing pediatric coding, billing coordination, and insurance credentialing. In this vital role, you will ensure accurate CPT, ICD-10, and HCPCS coding and compliance while serving as a key communicator between providers, billing entities, and patient families. The ideal candidate brings strong expertise in handling claims and denials and must be bilingual in English and Spanish to effectively explain financial responsibilities to parents and guardians.

Schedule:

• 8am-5pm EST

Responsibilities

• Review and code all pediatric patient encounters using CPT, ICD-10, and HCPCS while ensuring strict adherence to payer guidelines and clarifying documentation with providers
• Act as the primary link between the client and the external billing company to monitor claims, review EOBs, and coordinate necessary corrections
• Proactively resolve claim denials and rejections and assist with the formal appeals process to ensure maximum reimbursement
• Manage the full lifecycle of provider credentialing and recredentialing with insurance plans to maintain active payer participation
• Respond to parent/guardian inquiries regarding balances, copays, and deductibles while clearly explaining insurance benefits and financial responsibilities
• Assist with the diligent follow-up of outstanding balances and coordinate with the billing team to resolve aging accounts
• Field billing-related phone calls, respond to administrative emails, and collaborate with clinical and front-office staff to streamline office operations

Requirements

• Certified Professional Coder (CPC), CCS, or equivalent certification required
• Pediatric coding experience preferred
• Extensive experience with insurance credentialing
• Knowledge of revenue cycle management and claim lifecycle
• Familiarity with eClinicalWorks EMR preferred
• Strong understanding of copays, deductibles, coinsurance, and insurance processes
• Bilingual English/Spanish required

Independent Contractor Perks

• Permanent work from home
• Immediate hiring
• Health Insurance Coverage for eligible locations

Note

• Please click the Apply button to complete your application, including the assessment questions, technical check, and voice recording. Your hourly pay rate will be established based on your performance in the application process; submissions with all requirements fulfilled will receive priority review.