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Job Description
- Req#: 2025-R0441
- Understand billing workflows to support claim submissions, denials, and appeals tracking.
- Assist with payer follow-ups and tracking outstanding claims across RCM and BH teams.
- Work with billing vendors to ensure enrollments, claim submissions, and reports are aligned with PM Pediatrics’ needs.
- Help identify trends in denials, rejections, and payer issues, escalating as needed.
- Utilize Excel to generate, maintain, and distribute RCM and financial reports.
- Assist leadership with data entry, dashboard creation, and reconciliation of reports.
- Track revenue cycle KPIs, including claim turnaround times, denial rates, and payer trends.
- Organize and maintain documentation for compliance, payer audits, and reporting requirements.
- 2+ years of experience in a healthcare administrative role, preferably within RCM, medical billing, or provider enrollment.
- Strong proficiency in Microsoft Excel, including pivot tables, VLOOKUP, and data analysis.
- Knowledge of HCFA claim forms, including sorting, printing, and submission workflows.
- Familiarity with medical billing terminology, payer processes, and revenue cycle functions.
- Excellent organizational and multitasking skills in a fast-paced environment.
- Strong written and verbal communication skills, with the ability to interact across teams.
- Ability to work independently and proactively identify process improvements.
- Experience working with RCM and BH revenue cycle functions.
- Familiarity with payer portals and claims management systems.
- Understanding of denial management workflows and payer contract structures.
- Previous experience supporting leadership with data analysis, reporting, and financial tracking.
- Experience working with outsourced partners
It's fun to work in a company where people truly BELIEVE in what they're doing!
We're committed to bringing passion and customer focus to the business.
Summary
**This is a remote role**
PM Pediatrics is seeking a highly organized and detail-oriented Senior Billing Specialist to support the Revenue Cycle Management (RCM) team. This role is critical in ensuring the smooth operation of RCM related functions, including Excel-based reporting, payer project follow-ups, and supporting leadership with financial and operational data tracking.
The ideal candidate will have strong analytical and organizational skills, knowledge of medical billing workflows, and the ability to work with large datasets. This individual must be comfortable with billing terminology and payer processes to assist with reporting, denial trends, and operational efficiencies.Description
Billing & Payer Coordination:
Data & Reporting:
Qualifications
Preferred Qualifications:
If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!
EEO Statement
PM Pediatric Care is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, disability status, protected veteran status or any other characteristic protected by law.
About the company
The Urgent Care Just for Kids! With offices from coast-to-coast, we're here with specialized pediatric care - close to you, open 365 days a year until midnight. No Appointment Necessary.