Who We AreWe’re a boutique strategy firm working with early-stage health tech startups pushing the boundaries of traditional care models, care funding, and digital health infrastructure. Our clients often operate in reimbursement gray zones with unclear CPT codes, undefined coverage pathways, and business models that challenge legacy care definitions.
About the RoleWe are seeking a medical billing and coding expert who thrives at the intersection of strategy, compliance, and innovation. You’ll support high-growth startups and internal GTM teams by evaluating the reimbursement readiness of novel care delivery models, helping inform product design decisions, and codifying scalable strategies for commercialization. This is not a heads-down production coding role. This is a strategic advisory position for a coding leader who wants to shape the future of healthcare funding.
Key Responsibilities
- Analyze whether existing CPT, HCPCS, ICD-10, or revenue codes could apply to a client's service, software, or intervention, even tangentially.
- Conduct landscape scans for similar services, identify precedent coding models, and advise on likely payer positions.
- Highlight gaps, ambiguities, or limitations in current code sets that may impact revenue and scalability.
- Co-develop coding and billing playbooks for startup clients including documentation needs, coding narratives, and modifier usage.
- Advise on whether and how product design, clinical workflow, or documentation must evolve to align with existing reimbursement rules.
- Flag when novel code applications, demonstration projects, or direct-to-employer strategies may be more feasible than traditional coverage.
- Work with former health plan execs, care model designers, and policy strategists to align coding with broader go-to-market (GTM) strategy.
- Contribute to investor and partner-facing artifacts with succinct, clear coding rationale and path-to-revenue overviews.
Ideal Candidate
- 5+ years of experience in medical coding, revenue cycle, or reimbursement strategy - especially for emerging models of care (telehealth, remote monitoring, care coordination, digital therapeutics, AI, or SDOH).
- CPC, CCS-P, or CPMA certification required. CEMC, CRC, or payer-side auditing experience is a major plus.
- Prior experience advising startups, health tech vendors, or venture-backed companies preferred.
- Comfortable navigating non-traditional coding use cases and pushing back on conventional logic when needed.
- Familiar with CMS, MACs, and commercial payer documentation standards, including LCDs, NCDs, and coverage policies.
- Excellent written communication skills - you’ll be helping shape materials for client deliverables, not just internal use.
- Deeply curious, research-driven, and energized by a messy system that’s ripe for disruption.
Bonus Points
- Experience with CMS Innovation Center (CMMI) models, Medicaid State Plan Amendments, or value-based care.
- Familiarity with medical necessity language, prior auth requirements, and appeals strategy.
- Understanding of grant-based, philanthropic, or demonstration project reimbursement pathways.
Why Join Us?
- Work with mission-driven innovators who care about equitable, tech-enabled healthcare.
- Partner with visionary startups and health plans exploring the frontier of digital health and care delivery.
- Shape the future of how novel healthcare services are funded and scaled.
- Our team is a collective of experts who value collaborative problem-solving and a positive working environment.
To Apply:
Send your resume, relevant credentials, and a short note (or case study!) showing how you've helped a new care model navigate the reimbursement maze.
