Medical Coding Specialist
Pomelo Care
About us
Pomelo Care is a multi-disciplinary team of clinicians, engineers and problem solvers who are passionate about improving care for moms and babies. We are transforming outcomes for pregnant people and babies with evidence-based pregnancy and newborn care at scale. Our technology-driven care platform enables us to engage patients early, conduct individualized risk assessments for poor pregnancy outcomes, and deliver coordinated, personalized virtual care throughout pregnancy, NICU stays, and the first postpartum year. We measure ourselves by reductions in preterm births, NICU admissions, c-sections and maternal mortality; we improve outcomes and reduce healthcare spend.
Role Description
Your north star: Support the Pomelo clinical practice by ensuring accurate coding and billing of patient encounters.
In this role, you will have the following responsibilities:
- Review video, audio, and chat-based encounters and interactions with patients, ensuring completeness and accuracy of documentation
- Assign appropriate CPT and ICD-10 codes for each encounter, adhering to Medicaid rules and agreed-upon coding guidelines with our partner MCOs
- Submit $0 claims for codes that are recognized by state-level Medicaid fee schedules
- Continuously analyze coding patterns to identify opportunities for streamlining and improving the coding process, proposing recommendations for increased efficiency and accuracy
- Stay up to date with coding regulations, guidelines, and changes in Medicaid rules, ensuring compliance with coding and billing requirements
- Collaborate with the clinical team to resolve any coding-related queries or issues, providing guidance and clarification when necessary.
Who you are
- Certified Professional Coder (CPC) certification or equivalent coding certification
- 5+ years medical coding experience with expertise in coding for obstetrics/gynecology and pediatrics, including lactation
- In-depth knowledge of CPT and ICD-10 coding guidelines and Medicaid coding rules.
- Experience coding for telehealth companies preferred
- Experience with Principal Care Management (PCM) coding preferred
- Experience with coding asynchronous encounters preferred
- Experience with the athenahealth EHR preferred
- Meticulous attention to detail
- Passionate about maternal and child health
Why you should join our team
By joining Pomelo, you will get in on the ground floor of a fast-moving, well-funded, and mission-driven startup where you will have a profound impact on the patients we serve. And you'll learn, grow, be challenged, and have fun with your team while doing it.
We strive to create an environment where employees from all backgrounds are respected. We value working across disciplines, moving fast, data-driven decision making, learning, and always putting the patient first.
At Pomelo, we are committed to hiring the best team to improve outcomes for all mothers and babies, regardless of their background. We need diverse perspectives to reflect the diversity of problems we face and the population we serve. We look to hire people from a variety of backgrounds, including but not limited to race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status.
In accordance with New York City, Colorado, California, and other applicable laws, Pomelo Care is required to provide a reasonable estimate of the compensation range for this role. A reasonable estimate of the current salary range is $20 to $30 per hour.