Job Overview
We are seeking a certified Medical Coding & Revenue Cycle Specialist with pediatric experience to manage coding, billing coordination, and insurance credentialing. This role ensures accurate CPT, ICD-10, and HCPCS coding, compliance with payer guidelines, and smooth communication between providers, billing companies, and insurance plans.
The ideal candidate has strong revenue cycle knowledge, experience handling claims and denials, credentialing expertise, and the ability to clearly communicate financial information to parents/guardians. CPC, CCS, or equivalent certification is required. Bilingual English/Spanish is mandatory.
Schedule:
- 8am-5pm EST
Independent Contractor Perks:
- Permanent work from home
- Immediate hiring
- Health Insurance Coverage for eligible locations
Key Responsibilities
- Medical Coding & Documentation
- Review and code all pediatric patient encounters using CPT, ICD-10, and HCPCS
- Ensure compliance with payer guidelines and documentation standards
- Communicate with providers regarding documentation clarification when necessary
Revenue Cycle & Billing Coordination
- Serve as liaison between the client and external billing company
- Monitor claims, resolve denials and rejections, and assist with appeals
- Review EOBs and coordinate corrections as needed
Credentialing & Payer Relations
- Manage credentialing and recredentialing with insurance plans
- Maintain provider enrollment records
- Coordinate with credentialing agencies to ensure active payer participation
Patient Financial Communication
- Respond to parent/guardian inquiries regarding balances, copays, deductibles, and coinsurance
- Explain insurance benefits and patient financial responsibility
- Assist with follow-up on outstanding balances
Administrative Support
- Respond to emails and assist with office administrative tasks
- Field billing-related phone calls
- Collaborate with clinical and front office staff
Qualifications
- Certified Professional Coder (CPC), CCS, or equivalent certification required
Pediatric coding experience preferred - Extensive experience with insurance credentialing
- Knowledge of revenue cycle management and claim lifecycle
- Familiarity with eClinicalWorks EMR preferred
- Strong understanding of copays, deductibles, coinsurance, and insurance processes
- Bilingual English/Spanish required
Side Note
- This is a permanent work-from-home role under an Independent Contractor arrangement. Candidates must have their own computer and reliable internet connection, and are responsible for their own taxes and benefits. Professional hourly fees are established based on your performance in the application process.
Reminder
- Please follow the provided link to BruntWork’s Career Site to finish your initial application requirements, including the assessment questions, technical check, and voice recording. Submissions with all requirements fulfilled will receive priority review.