Senior Medical Coder

Who we are:

K Health is a venture-backed, fast-growing start-up with a mission to use the power of shared knowledge to get everyone access to higher quality, more affordable health care. We’re looking for mission-driven individuals to join our growing team and help us eliminate healthcare inequalities and build a better, healthier future for us all. 

Named as one of FastCompany's Most Innovative Health Companies of 2022 and to the 2021 CNBC Disruptor 50 list, K Health is using Artificial Intelligence (AI) to build the smartest digital healthcare platform in existence. Our data-driven app brings together the knowledge of thousands of doctors and the anonymous medical records of millions of people to help diagnose and treat what’s wrong. We offer a free symptom checker and 24/7 access to doctors to ask questions, refill prescriptions, get care for your kids, and more. Right from your phone—no insurance needed.

Since we were founded in 2016, K Health has raised over $270M in VC funding and our Series E funding round brought us to Unicorn status. Our current partners include the Mayo Clinic Platform, Anthem, and Maccabi Health Services.

About the role:

KHealth is looking for a dynamic individual who will serve as a subject matter expert of information regarding the impact of coding and documentation as it relates to patient care, quality outcomes measures, and correct reimbursement. You will play a critical role in ensuring accurate and compliant coding practices, conducting audits, and maintaining the highest level of data integrity. Your expertise in medical coding and auditing will contribute to the overall efficiency, regulatory compliance, and financial success of our organization.

What you'll be doing:

• Accurately assign diagnostic and procedural codes to medical records using ICD-10-CM, CPT, HCPCS, and other relevant coding systems.
• Review medical documentation to ensure coding accuracy, completeness, and adherence to established coding guidelines.
• Verify medical records contain appropriate documentation to justify the codes assigned.
• Resolve coding discrepancies or ambiguities by consulting with healthcare providers or relevant stakeholders.
• Ensure coding meets regulatory requirements and applicable coding guidelines, including Center for Medicare and Medicaid Services (CMS), Office of the Inspector General (OIG), HIPAA, and other relevant standards.
• Maintain up-to-date knowledge of coding guidelines, regulatory changes, and industry best practices, as well as payer specific requirements and regulations.
• Act as a liaison to clinical staff for any coding related issues or questions.  
• Educate and guide clinical staff on proper documentation and trends that could cause delay or denial of claim submission. 
• Conduct comprehensive audits of medical records, claims, and coding processes to identify potential compliance issues, coding errors, or fraudulent activities.
• Review charts for accuracy of CPT and ICD-10-CM diagnosis codes and documentation in support of all codes assigned.
• Prepare reports for the leadership team on findings from billing and coding audits, including a regular assessment of the company’s current coding performance, recent trends, and corrective actions taken.

What we're looking for:

• 6+ years of medical coding and auditing experience.
• In-depth knowledge of ICD-10-CM, CPT, insurance reimbursement, and coding and billing compliance regulations, including CMS guidelines and HIPAA requirements.
• Strong understanding of medical terminology, anatomy, physiology, and disease processes.
• Certification Professional Coder (CPC) certification, CCS, or CPMA certification required.
• Certified Professional Compliance Officer preferred.
• Experience in adult education and training required.
• Excellent analytical skills with a keen eye for detail and the ability to spot discrepancies.
• Proficient in using coding software, electronic health record (EHR) systems, G-suite, and related healthcare technology.
• Strong communication skills with the ability to effectively interact with physicians, healthcare providers, and other key stakeholders.

Benefits & Perks:  #LI-Hybrid

• 20 paid vacation days, 18 days sick leave, and 10 3-day weekends
• Hybrid work schedule with team meals and stocked fridges
• Commuter Benefits
• Community focused events
• Pension Plan
• Stipend per day for food
• Stock options for ever