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Billing Coordinator (Pediatric Therapy & Nursing Services)
MedCare Pediatric | Stafford, TX | Full-Time
MedCare Pediatric is seeking an experienced Billing Coordinator to join our centralized billing team. This role is ideal for a detail-oriented biller with a strong background in pediatric therapy and/or nursing services, and experience working with Texas Medicaid Managed Care Organizations (MCOs).
\n- Review and process pediatric therapy and nursing services documentation to ensure accurate and compliant billing
- Submit claims after verifying authorizations, units, modifiers, place of service, and provider information
- Manage and resolve claim denials, including authorization discrepancies, unit issues, timely filing, and missing information
- Work denials and underpayments from Texas Medicaid MCOs such as Texas Children’s Health Plan (TCHP), Superior HealthPlan, WellPoint, Molina Healthcare, UnitedHealthcare Community Plan, and Community Health Choice
- Prepare and submit corrected claims, reconsiderations, and appeals in accordance with payer guidelines
- Handle commercial payer denials (Aetna, Cigna, Blue Cross Blue Shield of Texas, UnitedHealthcare, Tricare, Optum)
- Verify insurance eligibility and authorization details (units, frequency, date ranges)
- Collaborate with clinical and operations teams to resolve documentation issues and prevent future denials
- Utilize EMR systems such as Raintree, KanTime, or similar platforms
- 1–3 years of billing experience in pediatric therapy and/or nursing services
- Experience working with Texas Medicaid MCOs and resolving denials
- Familiarity with authorization requirements, billing guidelines, and payer rules
- Experience with commercial insurance billing preferred
- EMR experience (Raintree, KanTime, or similar) preferred
- Strong attention to detail, organization, and follow-through
- Pay Range: $20.00 – $25.00 per hour
- 90-day performance review with potential pay adjustment
- Opportunity for growth within a supportive, mission-driven organization
Join a team dedicated to improving the lives of pediatric patients through high-quality care and strong operational support.
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