About Balboa Pediatrics
***This Position is In Person***
Balboa Pediatrics is a busy, family-focused pediatric practice in Encino, dedicated to providing high-quality care to infants, children, and adolescents. With a team of 11 physicians, we prioritize both exceptional patient care and a supportive, collaborative work environment for our staff.
This is a full-time, in-person position consisting of 8-hour shifts Monday through Friday, with required work every other Saturday (half-day). During weeks when a Saturday shift is scheduled, a half-day off will be provided during the week.
Position Overview
We are seeking a highly detail-oriented and experienced Pediatric Billing Specialist to manage all aspects of billing, coding, and claims. This role is critical to maintaining accurate, compliant billing practices and supporting the financial health of the practice.
The ideal candidate will have strong pediatric billing experience, a deep understanding of coding and payer requirements specific to pediatrics, and the ability to manage a high-volume, fast-paced workload with accuracy and efficiency.
Key Responsibilities
- Prepare and submit health insurance claims (CMS-1500 and electronic) accurately and in a timely manner
- Verify patient insurance eligibility and benefits, including pediatric-specific coverage nuances (e.g., well visits, vaccines)
- Post payments, reconcile EOBs/ERAs, and manage account adjustments
- Track, follow up on, and appeal denied or underpaid claims
- Ensure compliance with HIPAA, payer guidelines, and pediatric billing regulations
- Maintain accurate and complete patient billing records
- Generate and analyze billing and revenue cycle reports
- Work closely with providers and clinical staff to resolve coding and billing discrepancies
- Assist in training staff on billing workflows and best practices
- Stay current with pediatric coding updates, including immunization administration, preventive care, and modifier usage
- Manage AR for all doctors
Required Qualifications
- 6+ years of hands-on pediatric medical billing experience (required)
- Strong knowledge of pediatric-specific billing practices, including well-child visits, vaccines (VFC/private), and age-based coding guidelines
- Proficiency with CPT, ICD-10, and HCPCS coding, including modifiers commonly used in pediatrics
- Experience with CMS-1500 forms and electronic claim submission systems
- Ability to manage high-volume claims with accuracy and efficiency
- Strong understanding of insurance plans, payer rules, and denial management
- Excellent organizational, analytical, and communication skills
- Experience with practice management/EHR systems (Office Practicum strongly preferred)
Pay: $24.00 - $27.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid sick time
- Paid time off
- Retirement plan
Work Location: In person
