Pomelo Care is hiring a
Director, Medical Coding & Billing

Summary

The job is for a Medical Coding and Billing Manager at Pomelo Care, a startup focused on improving care for moms and babies. The role involves overseeing the medical coding and billing function, ensuring accurate coding and billing of services provided.

Requirements

• 7+ years revenue cycle experience required
• Certified Professional Coder (CPC) certification or equivalent coding certification preferred

Responsibilities

• Lead a team of medical coding and billing managers and specialists
• Streamline all internal processes and infrastructure for encounter coding and billing as we rapidly scale
• Collaborate with coding and billing team managers to build out trainings to support improved documentation for clinicians
• Stay up to date with coding regulations, guidelines, and changes in Medicaid rules, ensuring compliance with coding requirements
• Collaborate with our partnerships and customer success teams, as well as our health plan partners, on researching state-specific coding or billing related questions prior to health plan launches
• Track and report on billing and coding team KPIs, including team productivity, clean claims rate, outstanding A/R, denial rates, etc
• Identify and implement process improvements to enhance efficiency and effectiveness in revenue cycle operations and maximize value generation for the business
• Conduct regular audits to ensure accuracy of billing practices and no revenue or reporting leakage
• Work closely with Finance team on revenue reporting and reconciliation

Preferred Qualifications

5+ years medical coding experience preferred

Benefits

• 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
• 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
• Our salary ranges are based on paying competitively for our company’s size and industry, and are one part of the total compensation package that also includes equity, benefits, and other opportunities at Pomelo Care