Senior Medical Billing & Coding Specialist (Revenue Cycle – Pediatric Therapy | )
About The Talcott Center for Child Development
The Talcott Center for Child Development is a multidisciplinary pediatric provider based in Farmington, Connecticut, offering Applied Behavior Analysis (ABA), Speech Therapy, Occupational Therapy, Physical Therapy, Family Counseling, and Developmental Diagnostic Services.
Our model is built on integrated, family-centered care and a commitment to clinical and operational excellence. As we continue to grow, we are investing in building a best-in-class revenue cycle function that ensures accuracy, compliance, and long-term sustainability.
Position Overview
We are seeking a Senior Medical Billing & Coding Specialist with active coding certification (CPC, CCS, or equivalent) to take a leading role in strengthening our billing operations and revenue cycle performance.
This is a high-impact role responsible for:
- Ensuring coding accuracy and compliance across multiple service lines
- Driving clean claim performance and denial reduction
- Designing and reporting on key revenue cycle KPIs
- Identifying and implementing process improvements across billing and coding workflows
The ideal candidate brings deep expertise in outpatient therapy, diagnostic evaluation, and family-centered services billing, with the ability to move beyond execution into systems design and performance optimization.
Key Responsibilities
Billing & Revenue Cycle Execution
- Oversee accurate charge capture, coding validation, and claim submission across:
- ABA (Applied Behavior Analysis)
- Speech, Occupational, and Physical Therapy
- Family Counseling and Developmental Diagnostic Services
- Manage the full claim lifecycle: submission, adjudication, denial resolution, and appeals
- Ensure timely and accurate payment posting and account reconciliation
Coding & Compliance Leadership
- Serve as internal subject matter expert on CPT, ICD-10, and payer-specific billing requirements, including:
- Therapy and ABA service codes
- Diagnostic evaluation codes (e.g., 90791 and related services as applicable)
- Family counseling and developmental diagnostic services
- Conduct routine coding audits to ensure accuracy, compliance, and optimal reimbursement
- Interpret payer policies and navigate variability across commercial plans and managed care
- Partner with clinical leadership to ensure documentation supports billed services
KPI Development & Reporting
- Design, implement, and maintain revenue cycle KPIs and dashboards, including:
- Clean claim rate
- Denial rate and denial categories
- Days in Accounts Receivable (AR)
- Net collection rate
- Time to claim submission
- Produce weekly and monthly reporting with clear insights and actionable recommendations
- Establish baseline performance and track measurable improvement over time
Revenue Optimization & Process Improvement
- Analyze trends in denials, underpayments, and payer behavior across all service lines
- Identify root causes and implement corrective actions to improve reimbursement and reduce rework
- Develop and document standard operating procedures (SOPs) for billing and coding workflows
- Support scaling of billing operations as the organization expands
Cross-Functional Collaboration
- Collaborate with intake and client services teams on benefit structures and cost transparency when needed
- Serve as an internal resource on billing, coding, and payer-specific nuances
- Contribute to a culture of accountability, accuracy, and continuous improvement
Qualifications
Required
- Active certification: CPC (AAPC), CCS (AHIMA), or equivalent
- 3–5+ years of medical billing and coding experience, with increasing responsibility
- Strong knowledge of:
- Outpatient therapy billing (ABA, SLP, OT, PT)
- Diagnostic evaluation and family-centered service coding
- Demonstrated experience with denial management, appeals, and revenue cycle analysis
- Experience building or reporting on RCM KPIs and performance metrics
- Proficiency with EMR / billing systems (CentralReach preferred or similar platforms)
- Strong analytical, organizational, and communication skills
Preferred
- Experience in pediatric and multidisciplinary therapy settings
- Familiarity with multi-payer environments including Aetna, Anthem, UnitedHealthcare, Cigna, etc.
- Experience with process design, workflow optimization, or system implementation
- Comfort working in office or remote, collaborative environment
- Bachelor's Degree preferred
Compensation & Structure
This role is positioned as a senior individual contributor with ownership of revenue cycle performance.
- $90,000- $110,000 base salary, commensurate with experience
- Potential to exceed range for candidates with deep specialty expertise , education, extensive RCM experience and demonstrated impact
Optional performance bonus tied to:
- Clean claim rate improvement
- Denial reduction
- AR performance and collections
Work Structure
Onsite - Farmington CT
Benefits
- Health insurance
- 401(k) with company match
- Paid time off
- Opportunity to play a central role in building a high-performing revenue cycle function
Why This Role Matters
This role sits at the intersection of clinical integrity, financial performance, and operational scale.
You will help build the systems that ensure families can access care, clinicians are supported, and the organization continues to grow with strength and discipline.
Equal Opportunity Employer
The Talcott Center for Child Development is an equal opportunity employer and does not discriminate based on race, color, religion, sex, national origin, age, disability, genetics, veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by law.
Job Type: Full-time
Education:
- High school or equivalent (Preferred)
Work Location: In person
