Medical Coding Specialist (Temp)

📋 Description

• • Join Pomelo Care, a national leader in evidence-based healthcare for women and children, as a Medical Coding Specialist (Temp). In this critical role, you will be the linchpin supporting our clinical practice by ensuring the utmost accuracy and completeness in the coding of all patient encounters. Your work directly impacts our ability to provide high-quality, personalized care across a spectrum of services, from reproductive health and pregnancy to pediatrics and hormonal wellness.
• • Your primary responsibility will involve meticulously reviewing video, audio, and chat-based encounters between our clinical team and patients. This deep dive into patient interactions is essential for verifying the completeness and accuracy of the clinical documentation captured. You will be the guardian of data integrity, ensuring that every detail is captured and correctly represented.
• • A core function of this role is the precise application of appropriate CPT and ICD-10 codes for each patient encounter. This requires a deep understanding of federal and state regulations, as well as adherence to the specific coding guidelines agreed upon with our partner Managed Care Organizations (MCOs). Your expertise will ensure compliance and facilitate accurate billing and reimbursement.
• • You will act as a vital liaison between the clinical team and the coding function. When documentation is incomplete or requires clarification, you will proactively query clinicians to obtain the necessary additional information. This collaborative approach is key to enhancing the accuracy and completeness of the encounter data, ultimately leading to better patient care insights.
• • Beyond day-to-day coding, you will be empowered to continuously analyze coding patterns and identify areas for improvement. This includes proposing recommendations for streamlining processes, increasing efficiency, and further enhancing coding accuracy. Your insights will contribute to the ongoing optimization of our healthcare delivery model.
• • Staying abreast of the ever-evolving landscape of coding regulations, guidelines, and changes in Medicaid rules is paramount. You will be responsible for ensuring that all coding practices remain compliant with the latest requirements, safeguarding the integrity of our operations.
• • This temporary position offers a unique opportunity to contribute to a fast-moving, mission-driven startup that is making a profound impact on the lives of women and children. You will be part of a team dedicated to improving health outcomes and expanding access to quality care.
• • You will work with a diverse range of clinical services, including obstetrics/gynecology (with a focus on lactation support), pediatrics, therapy services, and nutritional counseling. This breadth of experience will allow you to hone your skills across various medical specialties.
• • The role requires a high degree of independence, critical thinking, and an unwavering attention to detail. You must be comfortable working with digital health platforms and possess a passion for maternal and child health, aligning with Pomelo Care's core mission.
• • By ensuring accurate coding, you directly contribute to Pomelo Care's ability to deliver comprehensive, multispecialty care that addresses the medical, behavioral, and social factors significantly impacting patient outcomes. Your work supports our partnerships with payers, employers, and providers, helping to expand access to quality healthcare across the system.
• • This is an opportunity to be at the forefront of innovative healthcare delivery, utilizing technology to provide accessible and high-quality care. You will be an integral part of a team that values learning, collaboration, and patient-centricity.