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. We’ve 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
- 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
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.
- Please note that any communication from our recruiters and hiring managers at Stellar Health about a job opportunity will only be made by a Stellar Health employee with an @stellar.health email address.
- Stellar Health does not utilize third-party agencies for recruitment services and does not conduct text message or chat-based interviews. Any other email addresses, agencies, or forums may be phishing scams designed to obtain your personal information.
- We will not ask you to provide personal or financial information, including, but not limited to, your social security number, online account passwords, credit card numbers, passport information, and other related banking information until we begin onboarding activities, which will be coordinated by a member of the Stellar Health People Ops Team with an @stellar.health email address.
If you are ever unsure whether you are in contact with a legitimate Stellar Health teammate, please contact ** Redacted **. If you believe you’ve 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.