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Billing Work
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• Full revenue cycle billing to include: charge posting, claim scrubbing, claim submission, clearing house rejections/edits, insurance payment posting, denial appeals, and reconciliation.
• Payor portal management: using log-ins, chat features, and online correction/resubmission tools to resolve issues while minimizing phone calls to payors.
• Account Management: engaging in hands-on account management and task work for assigned clients to balance leadership duties.
• AR Management to include reporting and daily AR work.
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Leadership & Oversight Work
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• Mentorship & supervision: leading a team of 8–12 billing specialists, fostering a positive, collaborative, and accountable work environment.
• Operational oversight: managing daily revenue cycle operations, specifically insurance/patient collections, denial management, and coverage planning.
• Performance management: monitoring team performance metrics, conducting evaluations, and ensuring the accuracy and timely submission of claims.
• Communication & escalation: serving as the bridge between management and the team, providing guidance, addressing conflicts, and acting as the escalation point for client issues.
• Project management: managing multiple projects concurrently, such as overseeing other billers' work and cleaning up neglected AR.
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What We're Looking For:
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• 8 years of medical billing outpatient physician services (5+ specifically in pediatrics)
• 2+ years supervising a team of 8 or more RCM staff
• Ability to identify reimbursement trends and root causes of denials
• Strong track record of denial resolution and successful appeals management
• Proficiency in at least 3 major EHR/Billing platforms
• Proven ability to manage 80-100 claims per day
• Professional communication with clients, providers, payers, and internal team
• Proactive, goal-oriented leadership with ability to foster a positive/motivating environment
• Demonstrated critical thinking and problem solving skills.
• CPC or CPB certification a plus
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What We Offer:
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• Competitive compensation commensurate with experience
• Full health benefits, time off, IRA matching and company equity
• Supportive team, clear expectations, and a stable, innovative and growing company
PedsOne is a Vermont “Best Places to Work” company with a national team of remote billers. We provide best-in-class full RCM billing services for private pediatric practices located throughout the US.