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).
Key Responsibilities:
- 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
Qualifications:
- 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
Compensation & Benefits:
- 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.
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
