Who We Are
We are Imagine Pediatrics, a devoted and compassionate, multi-disciplinary pediatrician-led medical group that is creating a world where every child with complex medical conditions gets the care and support they deserve. Energized by our mission to reimagine pediatric health care, we are pioneering virtual-first care services that include care coordination and around-the-clock access to complex-care clinicians from home. We don’t replace a child's existing care team. Instead, we collaborate to deliver continuous support to kids, so they can spend less time in the hospital and more time thriving at home and in their communities.
Every day we boldly challenge old approaches and seek out new and better ways to improve the health and lives of children with medical complexity. In partnership with caregivers, providers, and health plans, we break down the barriers that stand between families and quality care for their children. We know we can’t solve every challenge in the lives of these kids, but we can work tirelessly to give them, their families, and other caregivers the help and relief they need, right when they need it. We know a better approach to pediatric health care is within reach, and we are committed to seizing it today.
What We Live By
We’re guided by our five core values:
- Children first. We put the best interests of children above all. We are uncompromising in our commitment to improving the lives of children and families by bringing the best care to them.
- Earn trust. We cherish the trusting relationships we build with the children and families we serve, our partners, and each other. We seek first to understand and speak honestly.
- Innovate today. We refuse to accept the way things have always been done. Children and families are waiting for our help and their bravery demands that we relentlessly challenge assumptions to develop new approaches.
- Embrace humanity. We lead with empathy and authenticity, presuming competence and good intentions. When we stumble, we use the opportunity to learn and grow stronger.
- One team, diverse perspectives. We work alongside families as one team towards a shared purpose. We champion diversity and acknowledge the contributions of others.
About the Role:
The Medical Coding Manager oversees the coding teams daily operations, ensuring quality, accuracy, and compliance. Reporting to the Director of Value Capture Strategy & Revenue Cycle Management, the manager will provide direction on Medicaid coding guidelines by state(s) including E&M codes, HEDIS, and behavioral health across multiple departments. The role also ensures that CMS, NCQA, and state Medicaid policies and regulations are followed. You will:
- Provide tactical direction to the coding team, developing and implementing process, improvement plans, technology, and coding dashboards.
- Ensure the completion of reports, special projects, and Athena testing.
- Collaborate with the compliance coding auditor in designing and implementing coding education programs.
- Develop and implement coding dashboard. Ensure validity and submission on a weekly basis.
- Identify and assess possible resolution/action plans for any barriers/issues that may arise.
- Create and Implement policy and procedures, job Aides, and SOWs as needed.
- Stay updated on changes in coding regulation which include but are not limited to: Medicaid, CMS, NCQA, and HEDIS. Notify main stakeholders and implement necessary changes.
- Plan, direct, and implement procedures to ensure coding aligns with established policies and guidelines.
- Present and communicate to leadership
- Provide coverage for the coding team as needed
- Ensure medical documentation is timely and ready for billing
- Develop long term and short-term goals, objectives, plans, and programs
- Hold 1:1s with the team and conduct performance reviews
- Onboard new coders by providing education, and training in partnership with the compliance coding auditor.
- Account for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. This is done in adherence Official Guidelines for Coding and Reporting, Medicaid State Guidelines.
- Analyze medical records and identify documentation deficiencies. Track query process.
About You:
First and foremost, you’re passionate and committed to creating the world our sickest children deserve. You want an active role in building a diverse and values-driven culture. Things change quickly in a startup environment; you accept that and are willing to pivot quickly on priorities. In this role, you will need:
- High School Degree, Bachelors Degree preferred
- 5+ years coding experience, outpatient coding a plus
- Experience in multiple specialties including but not limited to: Pediatrics, E&M, Behavioral Health
- Must possess one of the following coding credentials: CPC, CCS, CCS-P, RHIT, or RHIA
- Experience in billing and claims submission a plus
- Ability to function well in a fast-paced environment, action-oriented with strong business acumen.
- Adaptable to change with strong organizational agility and the ability to work independently.
- Proficient computer skills including Microsoft Suite (Excel, Outlook, Teams, PowerPoint)
- EMR experience
- Excellent communication skills, both verbal and written.
What We Offer (Benefits + Perks)
The role offers a competitive base salary in addition to competitive company benefits package and eligibility to participate in an employee equity purchase program (as applicable). When determining compensation, we analyze and carefully consider several factors including job-related knowledge, skills and experience. These considerations may cause your compensation to vary.
We provide these additional benefits and perks:
- Competitive medical, dental, and vision insurance
- Healthcare and Dependent Care FSA; Company-funded HSA
- 401(k) with 4% match, vested 100% from day one
- Employer-paid short and long-term disability
- Life insurance at 1x annual salary
- 20 days PTO + 10 Company Holidays & 2 Floating Holidays
- Paid new parent leave
- Additional benefits to be detailed in offer
We Value Diversity, Equity, Inclusion and Belonging
We believe that creating a world where every child with complex medical conditions gets the care and support they deserve requires a diverse team with diverse perspectives. We're proud to be an equal opportunity employer. People seeking employment at Imagine Pediatrics are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information, or characteristics (or those of a family member), pregnancy or other status protected by applicable law.
