Medical Coding & Billing Specialist
Core
Medical Billing & Coding Specialist ensuring timely, accurate claims submission, compliance, and payment for pediatric patients with special health care needs.
Role type
Mid-level billing and coding specialist
Builds
Clean claims, optimized documentation, and reduced denials for pediatric care
Domain
Healthcare revenue cycle management (pediatrics)
Required skills
CPT, HCPCS, ICD-10 coding, Medicaid/commercial payer knowledge, telehealth billing, Athena EMR, Microsoft Excel, documentation review, denial management, eligibility validation
Preferred skills
Value-based care, capitation models, HEDIS quality measures, provider training
Technologies
Athena EMR, Microsoft Excel
Responsibilities
Submit clean claims with accurate codes; track and resolve denials; validate eligibility and authorization; review provider documentation and assign codes; educate providers on documentation improvements; maintain billing rules matrix
Seniority
Mid-level, hands-on IC
