Medical Coding & Billing Specialist

The role

This person will perform coding and billing tasks to ensure accurate claims submission and compliance. They will collaborate with providers, data teams, and partner operations to optimize documentation and workflows.

What you will do

• Submit clean, timely claims with accurate CPT, HCPCS, ICD-10 codes, and modifiers.
• Track and resolve denials, rejections, and underpayments.
• Validate eligibility, authorization, and proper billing pathways.
• Ensure accurate use of telehealth, SDOH, and preventive care codes.
• Coordinate with credentialing, partner success, and payer reps.
• Review provider documentation and assign accurate codes.
• Identify and escalate incomplete documentation or coding gaps.
• Educate providers to drive documentation improvement.
• Support implementation and testing of new documentation macros and templates.
• Maintain and contribute to the internal billing rules matrix.

Required qualifications

• AAPC Certified Professional Coder (CPC) required
• 3–5 years' experience in physician billing and coding
• Proficiency with Athena EMR and Microsoft Excel
• Deep understanding of CPT, HCPCS, ICD-10, HEDIS, and Medicaid/commercial payers

Nice to have

• pediatrics preferred
• Experience with telehealth billing, value-based care, capitation models, and quality measures a plus

Benefits

• 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

Before you apply

• Credentials will be verified prior to an offer of employment

About the company

Imagine Pediatrics is a tech enabled, pediatrician led medical group reimagining care for children with special health care needs. They deliver 24/7 virtual first and in home medical, behavioral, and social care.