drjobs Contract Medical Billing & Coding Consultant

Contract Medical Billing & Coding Consultant

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1 Vacancy
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Job Location drjobs

New York City, NY - USA

Hourly Salary drjobs

$ 125 - 275

Vacancy

1 Vacancy

Job Description

About Stellar Health:

Historically US Healthcare has relied on a fee-for-service reimbursement system where providers are paid based on the quantity of patient visits and procedures rather than the quality of health outcomes.

At Stellar Health we help primary care providers put patient health first. Our platform - a mix of technology people and analytics - supports providers at the point of care delivering real-time patient information activating practice staff and empowering providers and care teams with incentives that reward the work they are already doing to keep patients healthy. Using the Stellar App our web-based point-of-care tool; practices receive a simple checklist of recommended actions that support the best quality care. Providers and care teams are then paid monthly for each action they complete and Payors save money in reduced healthcare costs along the way.

Stellar is a US-based Health-tech backed by Top VCs (General Atlantic Point72 & Primary Venture Partners) with an established product & proven operating model. Weve shown that we make a real difference for physician practices and their patients.

Stellar Health is seeking a Billing and Coding Consultant with Medicare ACA (inclusive of ACO) risk adjustment expertise to support value-based care efforts on a part time/contract basis. Responsibilities include training 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. Strong communication organizational and problem-solving skills are needed. Deliverables include one-pagers decks consultation executive meetings and educational sessions. The contractor will investigate and develop comprehensive training materials with examples and then instruct diverse medical group personnel (medical assistants office managers physicians billers) on accurate diagnosis communication and documentation.

Role Stakeholders:

  • Internal Stellar Staff engaged in value-based care initiatives involving providers and payers.
  • Medical Group Stakeholders encompassing executive leadership such as CFO/CMO administrative personnel including office managers physicians Medical Assistants and billing staff.

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.
    • Accurate and Compliant Coding Guidelines:
    • General Claims Information

Required Skills and Experience:

  • 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.
  • Soft skills: 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.

Term and Contract Rate:

This part time contract role is for a six month term and for five to ten hours per week. The contract rate is between $125 - $275 per hour. Actual contracted rate will be based on the level of experience of the contractor.

Perks & Benefits:

Stellar offers a carefully curated selection of wellness benefits and perks to our employees:

  • Medical Dental and Vision Benefits
  • Flexible 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

Diversity is the key to our success.Stellar Health is an equal opportunity employer and we are open to all qualified applicants regardless of race color ancestry religion sex national origin sexual orientation age citizenship marital status disability gender identity or expression veteran status or any other legally protected status.

We believe that diverse teams -and the different identities cultures and life experiences our team members bring to the table- enable us to create amazing products find creative solutions to interesting problems and build an inclusive working environment.

Stellar Health Employment Privacy Notice

At Stellar Health your privacy and security as a job seeker is a priority no matter where you are in the interview process. As recruiting scams have become more prevalent please take note of the following practices to ensure the legitimacy of any interaction with our team.

If you are ever unsure whether you are in contact with a legitimate Stellar Health teammate please contact If you believe youve been a victim of a phishing attack please mark the communication as spam and immediately report it by contacting the U.S. Federal Trade Commission.


Required Experience:

Contract

Employment Type

Contract

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