Medical Billing Specialist

Who We Are

We are Imagine Pediatrics, a devoted and compassionate, multi-disciplinary pediatrician-led medical group that is creating a world where every child with complex medical conditions gets the care and support they deserve. Energized by our mission to reimagine pediatric health care, we are pioneering virtual-first care services that include care coordination and around-the-clock access to complex-care clinicians from home. We don’t replace a child's existing care team. Instead, we collaborate to deliver continuous support to kids, so they can spend less time in the hospital and more time thriving at home and in their communities.

Every day we boldly challenge old approaches and seek out new and better ways to improve the health and lives of children with medical complexity. In partnership with caregivers, providers, and health plans, we break down the barriers that stand between families and quality care for their children. We know we can’t solve every challenge in the lives of these kids, but we can work tirelessly to give them, their families, and other caregivers the help and relief they need, right when they need it. We know a better approach to pediatric health care is within reach, and we are committed to seizing it today.

What We Live By

We’re guided by our five core values:

• Children first. We put the best interests of children above all. We are uncompromising in our commitment to improving the lives of children and families by bringing the best care to them.
• Earn trust. We cherish the trusting relationships we build with the children and families we serve, our partners, and each other. We seek first to understand and speak honestly.
• Innovate today. We refuse to accept the way things have always been done. Children and families are waiting for our help and their bravery demands that we relentlessly challenge assumptions to develop new approaches.
• Embrace humanity. We lead with empathy and authenticity, presuming competence and good intentions. When we stumble, we use the opportunity to learn and grow stronger.
• One team, diverse perspectives. We work alongside families as one team towards a shared purpose. We champion diversity and acknowledge the contributions of others.
  
  

What You’ll Do

As a Medical Billing Specialist, you will be the main point of contact for billing, you will be responsible for ensuring timely submission of claims within 90 days from date of service. Familiarity with medical terminology, insurance procedures, healthcare laws, and regulations regarding medical billing are essential. You will need to verify accuracy of billing data for claim submissions, review denials and rejections, review patient insurance coverage and eligibility, collaborating with medical coders and other health care professionals to ensure accurate billing and to resolve discrepancies and re-submit claims as needed. Additional responsibilities are as follows:

• Process medical claims for services rendered to patients, including coded diagnoses and procedures accurately and in compliance with billing regulations.
• Submit claims electronically via EMR.
• Review and resolve claims denials, rejections by researching billing discrepancies, collaborating with Health Plan Operations, coding, and credentialing.
• Ability to contact State Medicaid and other Health Plans to get updates on claim status and support to address billing issues and/or inquiries as needed.
• Stay informed about changes in healthcare regulations, medical terminology, coding guidelines, and insurance policies affecting medical billing activities.
• Ensure compliance with HIPAA regulations and patient privacy laws in handling sensitive medical and financial information.
  
  

What You Bring & How You Qualify

First and foremost, you’re passionate and committed to reimagining pediatric health care and creating a world where every child with complex medical conditions gets the care and support, they deserve.

• High School Diploma/ Equivalent
• 3-5 years of medical billing experience
• Attention to detail.
• EMR experience
• 2-year degree from an accredited Medical Billing School a plus, not required
• CPC Certification
  
  

What We Offer (Benefits + Perks)

We offer a competitive compensation package in addition to competitive company benefits package and eligibility to participate in an employee equity purchase program (as applicable). When determining compensation, we analyze and carefully consider several factors including job-related knowledge, skills and experience. These considerations may cause your compensation to vary.

We provide these additional benefits and perks:

• 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
• Additional benefits to be detailed in offer
  
  

We Value Diversity, Equity, Inclusion and Belonging

We believe that creating a world where every child with complex medical conditions gets the care and support they deserve requires a diverse team with diverse perspectives. We're proud to be an equal opportunity employer. People seeking employment at Imagine Pediatrics are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information, or characteristics (or those of a family member), pregnancy or other status protected by applicable law.