Medical Billing Specialist

Pathway Geriatrics•Redmond, WA

18d•$60,000 - $75,000•Hybrid

About The Position

"A New Approach to an Age-Old Need" - Pathway Geriatrics is a nurse practitioner-owned medical startup headquartered in Redmond, WA, currently serving Greater Seattle. We provide in-home primary care services for homebound older adults. Said differently, we bring our medical services to our clients, who often can't leave their homes to get the specialized care they need. We have a uniquely deep background in technology (and tech startups), which heavily influences our workflows and culture. Our vision is to build a new kind of medical practice that melds the latest technologies and best practices with the caring hearts of top-tier professionals. We are looking for an experienced (5+ years) Medical Billing Specialist to join our team. You can expect to work from home 2 days a week and from our office in Redmond, WA, the rest of the time. Typical business hours are 9:00 AM to 5:00 PM, Monday - Friday. Pathway Geriatrics provides in-home primary care for homebound older adults. We currently have seven providers and are planning to continue expanding. Most of our clients live in Adult Family Homes (AFH), with a portion residing in assisted living facilities. We often have several clients at each home. Our providers aim to visit each facility every five to six weeks, and clients are seen based on medical necessity. Our providers also facilitate each client's medication and chronic care management between face-to-face appointments. We do our best to keep clients out of the emergency room. While we don't provide in-home urgent care, we can often manage urgent situations remotely with help from our local network of in-home diagnostic services. These include mobile imaging, ultrasound, phlebotomy, and urinalysis/urine cultures. The nature of our services means we often work with multiple parties when coordinating patient care. We typically have at least three clients per patient: the patient, their medical power of attorney, and their caregiver (typically an Adult Family Homeowner). A typical client is 75+ years old and often in their final few years of life. Most clients are homebound due to advanced dementia, but many also have other chronic diseases like osteoarthritis with contractures and pain, Parkinson's disease, heart failure, and diabetes. That said, we also work with younger adults who are homebound due to traumatic brain injuries, strokes, or mental health conditions. The family members and powers of attorney for our clients have varying levels of engagement and knowledge. We are transparent and communicative with them and aim to serve as a resource for them and their loved ones. Our practice approaches issues from a palliative care perspective. Our primary goal is to improve client comfort and quality of life while reducing unnecessary medications. We monitor as diseases progress and consider when they should transition onto hospice services. We usually remain as the client's PCP while on hospice, managing their end-of-life care. We see many routine problems day-to-day, but we are also frequently surprised by things we've never seen before. We often work with dementia-related behavioral concerns expressed through tearfulness, restlessness, physical aggression, combativeness, and sleep difficulty. As our clients grow weaker, they will transition from walker to wheelchair to hospital bed and require our assessments and orders to coordinate that equipment. We partner with local home health care teams when our client needs skilled nursing, physical and occupational therapy, speech therapy, and psych nursing. Adult family homes also have special state regulations, so they need us to provide specific orders and permissions for their inspection requirements. Our primary goal is to find a capable, kind, well-rounded person who will fit our startup culture and become a great teammate. We’re a small team looking to help the vulnerable older population we care for, and we’re looking for folks who share that mindset.

Requirements

5+ years of experience in billing/coding
Comfort working in modern, cloud‑based software and learning new tools
Confidence using technology and working independently in a fully digital environment
A relatable personality, comfortable conversing with a wide array of people on the phone
An ability to empathize with clients and their families. Our clients are often near end-of-life, which can lead to sensitive emotional conversations.
Comfort with adopting new technologies. Our platform constantly evolves, so our team must be comfortable frequently adopting new tools or workflows. We are a fully digital office; there is no paper whatsoever.

Nice To Haves

Certification as a Medical Biller / Coder

Responsibilities

Medical claims (submission, denials, rejections & appeals)
Patient billing (statements & collections)
New patient insurance eligibility verification
Provider credentialing
Value-based program metrics and attestations
Patient insurance and billing questions

Benefits

4 weeks PTO (vacation + sick leave)
Nine paid federal holidays (six are set, three you get to pick, including your birthday)
Top-notch low deductible Health Insurance (Medical, Dental, Vision) with a Healthcare FSA and Dependent Care FSA
401K with company matching (up to 4%)
Life & Disability Insurance
Workers Comp
An iPhone with an unlimited voice/data plan
A MacBook Pro with a nice monitor (for home use)
A multi-use Bluetooth headset
A mouse & keyboard