Medical Billing and Coding Consultant

Medical Billing & Coding Consultant

This is a hybrid role, with 3 in-office days required each week.

JOIN OUR TEAM

Onpoint Health Data is a dynamic, fast growing nonprofit company committed to delivering independent, reliable, and insightful data solutions to clients nationwide. If you are a motivated self-starter looking for the opportunity to work with emerging technologies and a collaborative, energetic team, Onpoint would be a perfect fit. We offer a competitive compensation and benefits package, and a great office space conveniently located in Portland's historic Old Port district.

SUMMARY

The Medical Billing & Coding Consultant serves as a vital resource within Onpoint, offering expert level guidance and clarification on coding related questions and issues. This role supports both internal teams and external clients, ensuring accurate and consistent practices across the organization. This subject matter expert (SME) uses their extensive knowledge of coding systems (e.g.ICD-10, CPT, HCPCS), payer requirements, payment mechanisms, and industry standards to respond to inquiries promptly and thoroughly and communicate guidance clearly, both written and verbally, to varied audiences.

Additionally, the SME proactively identifies trends, knowledge gaps, or recurring issues that signal the need for broader education or systemic improvements to Onpoint's products or services and may play an active role in managing or overseeing the process by which these improvements are designed and implemented. This position plays a key part in supporting coding accuracy related to analytics and data quality.

RESPONSIBILITIES

• Serve as SME for internal and external stakeholders, delivering expert guidance to resolve inquiries and concerns including:
  • Developing and presenting training curriculum based on identified external and internal needs
  • Designing value sets, such as identifying the set of CPT codes for CTs and MRIs
  • Responding to specific billing and coding inquiries in a timely manner
• Deliver comprehensive coding and documentation training for all newly onboarded staff and clients
• Provide annual review of code set updates to maintain accuracy
• Educate staff and clients on emerging trends to promote continuous improvement

Other
• Understand the value that Onpoint places on maintaining the confidentiality and integrity of our company and client data and meet applicable privacy and security compliance requirements
• Ensure that Onpoint and client data is accessed, handled, processed, transmitted, disclosed, and stored according to operational and IT policies and procedures
• Immediately report any suspected or actual violation of privacy and security policies or unauthorized access or disclosure of Onpoint or client data
• Understand that compliance with all privacy and security policies, laws, and regulations is part of each employee's annual performance evaluation
• Adhere to all policies and procedures as outlined in the Onpoint Health Data Employee Handbook
• Perform all other duties as assigned

QUALIFICATIONS

• 5+ years of medical billing and coding experience in a healthcare setting (inpatient, outpatient, or professional coding); preferred experience in multiple settings
• Deep understanding of ICD-10, CPT, HCPCS and official coding guidelines
• Deep understanding of payment mechanisms (e.g. Medicare OPPS)
• Proven ability to research and interpret complex coding guidelines and payer policies
• Experience providing coding support or education
• Extensive knowledge of Medicare and commercial payer reimbursement methodologies
• Advanced training or certification in specific disciplines or subject areas - e.g. Project Management Professional (PMP), AAPC, AHIMA, etc.
• Previous leadership experience preferred
• Excellent verbal and written communication skills
• Demonstrated ability to create specifications, user guides, and training materials
• Highly proficient in Microsoft Office Suite
• Extensive experience effectively handling multiple complex projects while successfully meeting deliverable dates
• Demonstrated success working independently, collaboratively within multidisciplinary teams, and in leadership roles
• Excellent organizational, interpersonal, and time management skills

Onpoint Health Data is an equal opportunity employer and prohibits discrimination and harassment of any kind. We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, gender identity, and/or expression, sexual orientation, marital status, disability, veteran status, or any other basis protected by applicable federal, state, or local law.