We are a team on a mission, to put accessible and affordable healthcare in the hands of every person on earth. Building on the success of Babylon in the United Kingdom, Rwanda and Canada, we are building a 50-state provider network in the United States. We want to provide health services to the Medicaid population, who are often underserved and overlooked. Today, we cover over 3.5 million members in the US.

By shifting the focus from sick care to preventative care, we’re creating a better model of healthcare. One that combines AI-powered technology with the highest quality clinical expertise—so we can help people live healthier, longer lives. With over 2,000 global employees, we’ve brought together one of the largest teams of healthcare professionals, scientists, mathematicians and engineers.

Our talented team is looking to hire the best clinicians and operations talent to build and scale in the US. We’re driven by people whose ideas and energy align with our mission and our values: to dream big, build fast and be brilliant.

The Opportunity

Babylon’s goal is to establish a strong network of primary care providers that deliver quality patient care, help patients live a healthier life, and support the growth of Babylon’s US presence with a tech-forward, virtual-first, value-based care model. In order to build and support a network of primary care providers, we will need a strong team of Primary care leaders to expand these efforts.

Clinical Coding Specialists are responsible for reviewing patient medical records for Medicare Advantage enrollees, and other groups/populations as assigned, to identify chronic conditions to be prioritized and addressed by healthcare providers. The review process includes working with multiple electronic health records, completing of pre-appointment reviews, completing post-appointment reviews, and reviewing capture of chronic conditions for physician incentives. They must maintain best practices for accurate data collection and adhere to Meritage policies and procedures.

Responsibilities:

• Evaluate the patient’s medical record and reports from the health plan to identify and document potential chronic conditions to be addressed by healthcare providers.
• Complete post-appointment review to assess HCC capture by providers and document findings.
• Work within a team to ensure ICD10 codes submitted by physicians are supported by documentation and provide feedback to inform physician education.
• Review, assess and provide feedback to mid-level providers conducting home visits.
• Document any additional HCC codes, when clinically indicated, on the ICE file.
• Report any findings of noncompliance for issues not related to HCC in the Secondary Pursuit file.
• Collaborate with team members to research or answer any coding questions that may arise.
• Assist in education of providers and staff regarding coding procedures and policies to ensure compliance.
• Respects patients by recognizing their rights and maintaining confidentiality.
• Promotes a team approach by encouraging communication among all members of the care team.
• Contributes to the team’s effort and success by accomplishing delegated tasks on time and meeting his/her daily and weekly job goals.
• Communicate with providers regarding HCC capture via the EHR tasking system.
• Maintain excellent customer relationships with providers, medical office staff, other department staff and health plan representatives.
• Complete assigned tasks daily and in a timely manner.
• Maintain current coding credential (if applicable).
• Assist in the training and orientation of new staff as directed.
• Performs other duties and projects as assigned that support the Care Management Team and other areas, departments and internal programs.

Qualifications and skills:

• High School diploma or equivalent.
• CPC or CCS certification required. CRC certification preferred.
• Minimum of 1-2 years current medical background with chart review experience.
• Expertise in RAF/HCC, ICD-10-CM and CPT.
• Working knowledge in HCC coding.
• Working knowledge of medical terminology, anatomy and physiology, disease processes and pharmacology.
• Able to work effectively on an independent basis or as part of a larger work team.
• Demonstrates critical thinking skills, sound judgement and a solid sense of accountability.
• Able to concurrently use different electronic health record systems as needed.
• Detail oriented and able to work as a collaborative and positive team member.
• Strong written, verbal and listening communication skills.
• Treats others in a respectful, kind and patient manner.
• Self-motivated and able to ask for assistance when needed.
• Flexible and adaptable to change.
• Medical office/chart review experience.
• One year of previous recent procedural/diagnosis coding, or equivalent work experience.
• Two years of customer service experience in a healthcare related setting.
• Experience with Accountable Care Organization (ACO) or Direct Contracting Entity (DCE)

What does Babylon offer our providers?

• Competitive compensation
• Flexible PTO
• Medical, Dental and Vision Insurance (full-time only)
• $60,000.00 - $81,000.00