Medical Coding & Billing Specialist (Healthcare)

TL;DR

Medical Coding & Billing Specialist (Healthcare): Managing claims submission and coding precision for children with special healthcare needs with an accent on billing strategy, compliance, and payment optimization. Focus on streamlining workflows, reducing denials, and improving provider documentation.

Location: Remote (United States)

Salary: $55,000–$65,000

Company

hirify.global is a tech-enabled, pediatrician-led medical group providing virtual-first and in-home care for children with special healthcare needs.

What you will do

• Submit clean claims using CPT, HCPCS, and ICD-10 codes and manage the denial resolution process.
• Validate eligibility, authorization, and billing pathways for patient encounters.
• Review provider documentation and assign accurate codes per ICD-10-CM and HEDIS guidelines.
• Maintain the internal billing rules matrix and collaborate with Data & Analytics to track A/R performance.
• Educate providers on documentation improvements and test new encounter note templates.

Requirements

• AAPC Certified Professional Coder (CPC) certification is required.
• 3–5 years of experience in physician billing and coding, preferably in pediatrics.
• Proficiency with Athena EMR and Microsoft Excel.
• Deep knowledge of CPT, HCPCS, ICD-10, HEDIS, and Medicaid/commercial payers.
• Must be based in the United States.

Nice to have

• Experience with telehealth billing and value-based care.
• Experience with capitation models and quality measures.

Culture & Benefits

• Comprehensive medical, dental, and vision insurance with company-funded HSA.
• 401(k) with 4% match, vested immediately.
• 20 days PTO plus 10 company holidays and 2 floating holidays.
• Paid new parent leave and employer-paid disability/life insurance.
• Employee equity purchase program eligibility.