Medical Coding Specialist

Headway is building a new mental healthcare system that everyone can access. Providers on Headway are responsible for their own coding and documentation, and we review that documentation against clinical documentation standards. As a Medical Coding Specialist, you are the coding and billing expert providers reach when they have questions about their documentation review results. You'll interpret results, determine whether a finding is actually correct, and explain it in language a clinician can act on. You'll also catch when a review result is wrong and get it fixed. A Certified Professional Coder (CPC) certification is required. All care on Headway is outpatient behavioral health, delivered in person or virtually. This is not an auditing role and not a production coding role.

Responsibilities

Interpret behavioral health documentation and coding review results (ICD-10-CM and CPT) and translate them into clear, actionable provider education and feedback; Determine whether a flagged finding is accurate, confirming genuine documentation and coding errors and identifying findings that were flagged incorrectly so they can be corrected and escalated; Serve as a subject matter expert by answering provider and internal-team questions on behavioral health coding and documentation (ICD-10-CM and CPT) and billing findings; Deliver clear, accurate, and empathetic responses to providers through our support channels (e.g., Zendesk); Contribute to provider education efforts, including drafting content, identifying documentation gaps, and advising on documentation standards; Partner with our Customer Experience (CX) team to build knowledge base content and resources that help resolve more questions without direct SME support; Provide insights on coding trends, identify risk areas, and recommend improvements to tooling, process, and training; Collaborate with cross-functional partners on initiatives that improve the provider audit-support experience; Stay current with evolving coding guidelines, payer rules, and industry standards through continuing education and independent learning

Requirements

Have a CPC certification (required) and 1-2 years of experience in outpatient or professional-services coding, ideally within a behavioral health setting; Possess a strong grasp of ICD-10-CM, CPT, and HCPCS coding guidelines and the documentation requirements; Communicate clearly and empathetically, especially when educating providers or discussing sensitive feedback; Have the ability to balance supportive coaching and enforcing provider policies regarding payer standards and compliance regulations; Can independently reach the correct coding and documentation conclusion on a behavioral health note and defend it, including disagreeing with a review result when the documentation supports you; Are energized by making providers and frontline teams self-sufficient, rather than by reviewing charts; Bring a high level of attention to detail and comfort working independently in a fast-paced, digital environment; Are tech-savvy: you can navigate Google Workspace, Zoom, and EMR platforms, or you're excited to learn; Are energized by working cross-functionally and driving quality at scale in a tech-forward setting

Nice to have

CPMA certification; Previously educated providers on medical decision making (MDM) for outpatient Evaluation and Management (E/M) services

Benefits

Equity compensation; Medical, Dental, and Vision coverage; HSA/FSA; 401K; Work-from-Home Stipend; Therapy Reimbursement; 16-week parental leave for eligible employees; Carrot Fertility annual reimbursement and membership; 13 paid holidays each year as well as a Holiday Break during the week between December 25th and December 31st; Flexible PTO; Employee Assistance Program (EAP); Training and professional development