Medical Coding Specialist

Summary

Join Pomelo Care, a dynamic healthcare technology company, as a Medical Coder. You will play a crucial role in ensuring accurate coding of patient encounters, contributing to improved maternal and child health outcomes. This position requires a Certified Professional Coder (CPC) certification or equivalent, along with 5+ years of medical coding experience in obstetrics/gynecology, pediatrics, and related areas. You will review and code video, audio, and chat-based encounters, query the clinical team for clarification, and analyze coding patterns to identify areas for improvement. Pomelo offers a fast-paced, mission-driven environment with opportunities for growth and impact.

Requirements

• Certified Professional Coder (CPC) certification or equivalent coding certification
• 5+ years medical coding experience with expertise in outpatient coding for obstetrics/gynecology (including lactation), pediatrics, therapy and nutritional counseling
• 5+ years coding in an EHR with recent experience in Athena preferred
• In-depth knowledge of CPT and ICD-10 coding guidelines and Medicaid coding rules
• Independent, critical thinker with meticulous attention to detail
• Passionate about maternal and child health

Responsibilities

• Review video, audio, and chat-based encounters and interactions with patients, ensuring completeness and accuracy of clinical documentation
• Accurately apply appropriate CPT and ICD-10 codes for each encounter, adhering to federal and state rules and agreed-upon coding guidelines with our partner MCOs
• Query clinical team to obtain additional, clarifying documentation to improve the accuracy and completeness of the encounter data
• 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

Preferred Qualifications

• Experience coding for telehealth companies preferred
• Experience with coding asynchronous encounters preferred
• Experience with billing preferred

Benefits

Remote work