Medical Biller/Coder, OB/GYN
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Job Description
Medical Biller/Coder ensuring accurate coding and compliance for women's health services at Diana Health. Supporting revenue cycle processes and collaborating with clinical staff for optimal reimbursements.
Responsibilities:
- Review clinical documentation and diagnostic results to ensure accurate CPT and ICD-10 coding.
- Validate medical necessity and ensure coding aligns with CMS and payer-specific guidelines.
- Process charge captures and review billing system edits to prevent claim denials.
- Collaborate with providers and billing teams to clarify documentation or coding inconsistencies.
- Identify coding trends, resolve payer denials, and provide recommendations for improvement.
- Assist with provider education on documentation and coding compliance.
- Maintain production standards and report daily coding productivity and quality metrics.
Requirements:
- High School Diploma or GED required.
- Completion of a formal coding program (AHIMA, CCS, or AAPC preferred).
- Minimum of 3 years’ applied coding experience OR 5 years of OB/GYN coding experience in a physician billing or revenue cycle setting; Emphasize on OB/GYN coding!
- Proficiency in ICD-10, CPT, medical terminology, anatomy, and health record content.
- Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) preferred.
- Non-certified coders with strong experience may be required to obtain certification within an agreed timeframe.
- In-depth knowledge of Medicare, Medicaid, and managed care plans (HMO, PPO, POS, Indemnity).
- Understanding of HIPAA, Medicare Fraud and Abuse regulations, and EHR/Billing systems.
- Strong analytical and organizational skills with attention to detail.
- Proficiency in Microsoft Office (Word, Excel, Outlook) and healthcare billing platforms.
- Excellent verbal and written communication skills.
- Customer-focused approach and ability to work effectively with clinical staff and patients.
Benefits:
- Competitive compensation
- Medical, dental & vision plans, with an HSA/FSA option
- 401(k) with employer match
- Paid time off
- Paid parental leave
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