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.