Medical Billing & Coding Consultant

Summary

Join Stellar Health as a Billing and Coding Consultant to support value-based care efforts. This part-time contract role involves training internal staff and medical group stakeholders on accurate coding, claims submission, payer rules, and HIPAA compliance. You will create comprehensive training materials and deliver educational sessions to diverse medical group personnel. The ideal candidate possesses in-depth knowledge of Medicare and ACA risk adjustment and over 7 years of experience in primary care billing and coding. This six-month contract offers 5-10 hours per week at an hourly rate between $125-$275, depending on experience. Stellar Health offers various benefits, including medical, dental, and vision benefits; unlimited PTO; paid family leave; and wellness stipends.

Requirements

• Over 7 years of experience in primary care billing and coding
• Comprehensive knowledge of payer regulations, including Medicare, Medicaid, and commercial plans
• Thorough understanding of HIPAA compliance requirements
• Attention to detail, strong communication skills and ability to refine messaging to executive and junior audiences, and problem-solving abilities
• Strong organizational skills are crucial for success in this role. These skills encompass the ability to effectively manage time, prioritize tasks, maintain accurate records, and adhere to established procedures. Attention to detail and a systematic approach to work are also integral components of strong organizational abilities, ensuring efficiency and accuracy in all responsibilities

Responsibilities

• Train internal staff and medical group stakeholders (executives to billing staff) on accurate coding (ICD-10 and CPTII), claims submission, payer rules (Medicare, Medicaid, commercial), and HIPAA compliance, with a primary care focus
• Develop comprehensive training materials with examples
• Instruct diverse medical group personnel (medical assistants, office managers, physicians, billers) on accurate diagnosis communication and documentation
• Investigate and develop comprehensive training materials with examples

Preferred Qualifications

• In-depth knowledge of Medicare and ACA risk adjustment methodologies, reporting, and their implications
• Proven ability to provide training and education on: Precise Code Assignment: Translating patient diagnoses, procedures, and services into the correct ICD-10, CPT, and HCPCS codes, minimizing errors
• Staying Abreast of Updates: Continuously monitoring and implementing changes in coding guidelines, regulations, and payer policies (e.g., Medicare, Medicaid, commercial insurers)
• Documentation Review: Identifying potential documentation gaps, and collaborating with clinical staff for clarification
• Compliance Adherence: Ensuring all coding practices adhere to federal, state, and local regulations, mitigating the risk of audits and penalties
• Claim submission support includes identifying and helping to correct common issues related to the full submission of diagnosis codes. This assistance supports the preparation of clean electronic claims for insurance payers by ensuring adherence to specific payer requirements and formats

Benefits

• Medical, Dental and Vision Benefits
• Unlimited PTO
• Universal Paid Family Leave
• Company sponsored One Medical memberships and Citibike memberships
• Medical Travel Benefits
• A monthly wellness stipend that gives employees the freedom to choose where they spend their cash, whether it be on wellness, pet care, childcare, WFH items, or charitable donations
• Stock Options & a 401k matching program
• Career development opportunities like Manager Training, coaching, and an internal mobility program
• A broad calendar of company sponsored social events that for our in-office and remote employees