In-House Medical Biller (Pediatrics / Outpatient Practice)

We are a growing pediatric practice seeking an experienced, detail-oriented In-House Medical Biller to take ownership of our billing and revenue cycle processes.

This is not an entry-level role. We are intentionally bringing billing in-house to improve accuracy, reduce denials, and create a more consistent patient and provider experience.

The ideal candidate has strong pediatric billing experience, understands the nuances of vaccine billing and Medicaid plans, and is comfortable working independently while collaborating with physicians and front desk staff.

Key Responsibilities

• Submit, track, and manage insurance claims (electronic and paper)
• Own and actively manage accounts receivable and aging reports
• Identify, investigate, and resolve denied or unpaid claims
• Ensure accurate coding (CPT, ICD-10, modifiers including modifier 25)
• Manage pediatric-specific billing workflows (well visits, sick visits, vaccines)
• Work closely with providers to correct documentation and prevent denials
• Verify insurance eligibility and benefits, especially Medicaid plans
• Post payments and reconcile accounts
• Communicate with insurance companies regarding claim status
• Help identify and improve billing workflows to reduce errors and increase efficiency

Required Qualifications

• 3+ years of medical billing experience (pediatrics strongly preferred)
• Strong knowledge of CPT, ICD-10, and payer guidelines
• Experience with pediatric billing, including:
• Vaccines (including VFC workflows)
• Medicaid and managed Medicaid plans
• Well visit + sick visit coding and modifier usage
• Proven ability to manage A/R and resolve denials independently
• Experience with EMR/EHR and billing systems
• Strong attention to detail and problem-solving skills
• Excellent communication and organizational skills

Preferred (but not required)

• Certified Professional Biller (CPB) or CPC
• Experience in a busy outpatient pediatric practice
• Familiarity with [your EMR system]

What We’re Looking For

• Someone who takes ownership of the billing process, not just completes tasks
• A proactive problem-solver who identifies issues and helps fix them
• A team player who communicates effectively with clinical and front desk staff
• Someone who wants to grow with a collaborative, forward-thinking practice

Why Join Us

• Supportive, team-oriented environment
• Opportunity to build and improve internal billing systems
• Direct collaboration with physicians and leadership
• Meaningful role impacting both patient experience and practice growth

Pay: $20.00 - $28.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Application Question(s):

• Describe your hands-on experience with pediatric billing, including vaccines.
• How do you bill a well visit when a sick concern is addressed at the same visit?
• Walk me through how you handle a denied claim from start to resolution.
• What aspects of accounts receivable are you comfortable managing independently?
• How many claims per day do you typically manage or follow up on?

Work Location: In person