Coding Analyst

Coding AnalystUnified Women's Healthcare is a company dedicated to caring for OB/GYN providers who care for others, be they physicians or their support staff. A team of like-minded professionals with significant business and healthcare experience, we operate with a singular mindset - great care needs great care. We take great pride in not just speaking about this, but executing on it.As a company, our mission is to be an indispensable source of business knowledge, innovation and support to the practices in our network.

We are advocates for our OB/GYN medical affiliates - enabling them to focus solely on the practice of medicine while we focus on the business of medicine.We are action oriented. We strategize, implement and execute - on behalf of the practices we serve.The Coding Analyst is entrusted with the job of reviewing, auditing and coding provider's documentation for the purpose of reimbursement, training, education and compliance using ICD-10 and CPT codes. The successful applicant will serve as an information resource and guide to our providers, clinical staff, practice managers, members of the Revenue Cycle team and other leadership.

This position will be directly involved in analyzing pre-bill claim edits, claim denials and AR management, and working alongside the Revenue Specialists, will review and amend denied claims to ensure accurate coding and adherence to payor policy requirements. The Coding Analyst will assist the Revenue Cycle Manager in proactive audits of medical charts and records for compliance with federal coding regulations and guidelines. This role utilizes knowledge of client systems and procedures to provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements.

The Coding Analyst reviews, develops, and/or modifies client procedures, systems, and protocols to achieve and maintain compatibility with billing requirements and compliance standards.ResponsibilitiesProvide second-level review of billing performances to ensure compliance with legal and procedural policies and to ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practicesAudit medical record documentation to identify under-coded and over-coded services; prepare reports of findings and meet with providers to provide education and training on accurate coding practices and compliance issuesInteract with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations; obtain clarification of conflicting, ambiguous, or non-specific documentation through provider queriesSubmit any issues or trends found within documentation by a physician and /or physician extender to Revenue Cycle Manager and/or practice administratorInteract with Revenue Specialists and practice billing specialists to ensure appropriate and complete follow-up of patient accounts to maximize reimbursement through AR management processes, including corrections and resubmissions as neededAnalyze individual payor performances regarding fee schedule reimbursements and trendsResearch, analyze, and respond to inquiries regarding compliance, payor policies and guidelines, inappropriate coding, denials, and billable servicesMonitor and distribute communications regarding payor policy changes and updates, in relation to our provider specialtiesProvide training, guidance and oversight to staff less experienced in coding guidelinesServe as an information resource and guide to clinicians, champion the need to change coding behaviors and serve as subject matter expertTrain, instruct, and provide support to medical providers and practice billing specialists as appropriate regarding coding compliance, documentation, and regulatory provisions, and third-party payor requirementsReview, develop, modify, and adapt relevant client procedures, protocols, and data management systems to ensure compliance with organization's policiesInteract with providers and management to review and/or implement codes and to update charge documentsIllustrate excellent knowledge of healthcare industry regarding the revenue cycle, coding, claims, and state insurance lawsEnsure strict confidentiality of financial and medical recordsPerform miscellaneous job-related duties as assignedQualificationsCertified Professional Coder (CPC) certification requiredMinimum of 5 years' experience as a biller, collector, coder, or back office support staff, or other equivalent medical industry experienceOB/GYN experience preferred, but not requiredAssociates degree from an accredited university preferredKnowledge of auditing concepts and principlesAdvanced knowledge of medical coding and billing systems and regulatory requirementsAbility to use independent judgment and to manage and impart confidential informationAbility to analyze and solve problemsStrong communication and interpersonal skillsKnowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentationKnowledge of current and developing issues and trends in medical coding procedures requirementsWe're here for you—both personally and professionally.Our benefits are designed to support you and your family at every stage of life. From health and wellness to financial security and career growth, we offer a comprehensive package to help you thrive.Here's a look at what we offer:Health CoverageMedical, dental, and vision plans, fertility benefits, and supplemental insurance options.Paid Time OffVacation, personal days, and paid holidays to help you recharge.Financial & Retirement Planning401(k) with employer contribution, plus Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs).Income ProtectionShort- and long-term disability, paid parental leave, basic life insurance, and optional additional coverage.Wellbeing SupportEmployee Assistance Program, commuter benefits, pet insurance, and identity theft protection.Professional DevelopmentOpportunities and resources to support your career growth.