Certified Pediatric Coder

Pediatrica Health Group • Miami, FL

2d • Onsite

About The Position

This position is responsible for reviewing, coding, and submitting accurate claims for pediatric medical services while ensuring compliance with current coding regulations and insurance requirements. The ideal candidate will have expertise in pediatric coding guidelines and work collaboratively with clinical and billing teams.

Requirements

• High school diploma or equivalent required.
• Certification as a Certified Pediatric Coder (CPC-P) required.
• Minimum of two years of medical coding experience, preferably in a pediatric healthcare setting.
• In-depth knowledge of pediatric-specific coding, medical terminology, and insurance guidelines.
• Proficient in using coding software, EMR systems, and Microsoft Office applications.
• Excellent attention to detail and organizational skills.
• Strong verbal and written communication skills.
• Commitment to maintaining patient confidentiality and adhering to HIPAA regulations.

Responsibilities

• Review clinical documentation and assign appropriate ICD-10, CPT, and HCPCS codes for pediatric diagnoses and procedures.
• Ensure coding compliance with federal regulations, payer policies, and organizational standards.
• Query providers when necessary for additional information or clarification to ensure accurate coding.
• Assist in the education of providers and staff regarding coding updates, documentation improvement, and regulatory requirements.
• Audit coded data for accuracy and provide feedback to clinical staff as needed.
• Submit clean claims for reimbursement in a timely manner and assist with denial management processes related to coding issues.
• Stay current with changes in coding guidelines, payer requirements, and pediatric coding best practices.
• Support revenue cycle management by ensuring optimal coding accuracy and maximizing reimbursement.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED