Professional Coder - Maternal-Fetal Medicine

Overview

Maternal Fetal Medicine (MFM) Professional Coder position responsible for complex professional coding across multiple settings, including office/clinic, hospital outpatient, ED/urgent care, ASC, SNF/nursing home, and telehealth. Applies advanced coding judgment, payer policy interpretation, and documentation standards to support compliant reimbursement, wRVU integrity, and audit defensibility in an academic and research enterprise.

Responsibilities

• Code complex professional encounters and procedures; ensure correct sequencing, modifiers, E/M level selection, and documentation alignment. Advanced expertise in ICD-10-CM, CPT, HCPCS, and modifiers; strong E/M coding proficiency and payer policy interpretation.
• Resolve coding-related edits and denials by identifying root cause, coordinating documentation clarification, and supporting rebilling actions as applicable.
• Apply payer medical policies, NCCI concepts, global service considerations, and telehealth coding rules as relevant to professional fee claims.
• Provide real-time guidance to peers on standard coding scenarios; promote consistency through best-practice sharing.
• Participate in internal quality review programs and implement education/corrective actions based on findings.
• Proficiency in Epic professional coding work queues and encoder tools; ability to efficiently review documentation in the EHR across settings.
• Analytical problem solving for denial/edits prevention; ability to identify documentation improvement opportunities and support compliant query workflows.
• Working knowledge of risk adjustment concepts and HCC validation where applicable to supported populations.

General Job Duties

• Performs other duties as assigned

Education and Experience

Education: High School diploma or GED required.

Experience: At least 3 years of experience in physician/provider coding required.

Certification/License/Registration: CPC or CCS-P required

Current OU Health Employees - Please login to access internal resources. OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, creates peace of mind for you and your family.