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Medical Billing and Coding Specialist

Grayson Pediatrics
Loganville, GA Full Time
POSTED ON 3/30/2025
AVAILABLE BEFORE 5/7/2025

About us

Grayson Pediatrics is a small business in Loganville, GA. We are professional, fast-paced, inclusive and our goal is to Serve the needs of the children in our communities with compassion and empathy. We accomplish this by partnering with our families to understand and meet their child(ren)'s individual needs. .

Our work environment includes:

  • Modern office setting
  • Growth opportunities
  • Lively atmosphere
  • Casual work attire

The right candidate for this position will like to solve puzzles and is a master of organization and details. The ideal candidate will have at least 1 year of pediatric billing and coding experience, have experience with AthenaHealth (EHR), and have worked in concert with the AtheanHealth Billing team to successfully manage the overall RCM process.

Grayson Pediatrics, LLC has partnered with AthenaHealth's Billing Services team to handle the primary coding, insurance filing, appeals, working defined rejections and declinations, and sending patient statements (electronically and in paper form). The Billing Specialist will need to:

  • Successfully work the office-assigned claim holds, rejections, and declinations accurately and promptly
  • Promptly respond to internal and external correspondence (email, text, EHR, etc.)
  • Contact the patient or responsible party to obtain information needed to successfully get the claim paid and to collect outstanding payments
  • Verify patient insurance coverage and process claims for reimbursement
  • Frequently run A/R aging insurance and patient reports and understand the specifics for claims greater than 60 days
  • Report monthly to management and leadership the billing performance metrics, the drivers of the results, and actions taken to optimize results
  • Assign appropriate ICD-10, ICD-9, DRG codes, and CPT II codes to medical procedures and diagnoses
  • Review and analyze medical records to ensure accurate coding and billing
  • Maintain patient confidentiality and adhere to HIPAA regulations and other company policies
  • Stay updated on changes in medical coding guidelines and regulations
  • Follow up on claims yet to be paid until they have been resolved
  • Work with collections agency for delinquiate accounts
  • Adhere to all ethical billing and coding practices

Skills:

  • Proficient in the AthanaHealth system
  • Strong knowledge of ICD-10, ICD-9, CPT II, and DRG coding principles
  • Attention to detail and accuracy in the coding and billing process
  • A holistic working knowledge of the RCM process
  • Excellent communication skills to interact with healthcare providers, insurance companies, patients, and responsible parties.
  • Ability to work independently and manage time effectively
  • Knowledge of pediatric medical terminology, pharmaceuticals, anatomy, and physiology

Job Type: Full-time

Pay: From $20.00 per hour

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Employee assistance program
  • Employee discount
  • Health insurance
  • Life insurance
  • Paid time off
  • Tuition reimbursement
  • Vision insurance

Schedule:

  • 8 hour shift
  • Monday to Friday

Experience:

  • ICD-10: 1 year (Required)

Work Location: In person

Salary : $20

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