Job Summary

Medical Billing Specialists provide best-in-class billing services to our private pediatric practice clients. Review claims for accuracy; oversee processing of claims to payers; resolve insurance company payments that are late, underpaid or denied; work closely with providers, practice managers and staff to implement best practice protocols.

Responsibilities

• Learn and become proficient with the premiere pediatric system in the industry- Partner Billing System by Physician’s Computer Company (PCC).
• Efficiently analyze insurance claims throughout the submission process, ensuring claims are accurately coded in a timely fashion, and for optimum reimbursement and compliance.
• Ensure that all claims reach the payers, and independently resolve any issues (underpayments, denials, etc.) with the claims so they are paid fully and on time.
• Post payments, organize the processing of patient correspondence and statements.
• Answer phone inquiries from patients regarding benefit coverage and making payments.
• Consult with the practice manager, front desk staff and providers on a regular basis to implement and maintain quality assurance, optimal billing procedures and client satisfaction.

Qualifications

• 1 recent year of medical (physician services) billing 
• Knowledge of insurance payment posting, demonstrated use of CARC codes and denials 
• Experienced in navigating payer websites for policies and rules, as well as conducting general online research
• Working knowledge of medical terminology, anatomy and physiology
• Strong communication and interpersonal skills
• Demonstrated comfort with computer technology 
• Established proficiency in or ability to quickly become proficient in the Google Workspace (G-Suite): Gmail, Google Drive, Docs, Sheets, Meet, etc.
• Strong time management and customer service skills
• Strong attention to detail and follow through, able to multitask
• Demonstrated ability to self-manage

Ideal Characteristics

• Passion for achieving excellence
• Works with a blend of quality, speed, and accuracy
• Able to work independently and on a team
• Effective and efficient with problem solving
• Motivated learner who is able to grow through challenges
• Familiarity with the proper use of ICD-10, CPT, HCPCS coding rules
• Knowledge of Medicare’s National Correct Coding Initiatives edits
• Primary care or Pediatric billing experience
• AAPC, CPC medical coder certification

Benefits

• Health, vision, dental insurance, and short-term disability
• CTO accrued from the 1st day of employment, beginning with 2 weeks
• 6 paid holidays with 5 additional paid days
• 3 paid days for personal emergency
• Paid time off for volunteer community service
• Paid parental leave
• Employee retirement account with 3% matching
• Employee Assistance Program

PedsOne is an E-Verify employer