Medical Billing Specialist

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.


  • 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.


  • 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

Additional Qualifications for Hybrid Staff

Our local, onsite staff have the option to work a hybrid schedule with 3 days in office, and 2 days remote.  Requirements for working from home include:

  • A private, dedicated space to ensure HIPAA compliance
  • Sufficiently high speed and reliable internet service to perform the job. Download speed: optimal 10-20 mbps. Upload speed: over 5 mbps. Latency: under 50 is ideal. (Anything above 100 ms will not work.) A speed test for these metrics is available at


  • 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