Medical Biller/Coder (OB/GYN coder)
About the Company
Diana Health is a network of modern women's health practices working in partnership with hospitals to reimagine the maternity and women's healthcare experience. We combine a tech-enabled, wellness-focused care program with a clinical system that helps us drive continuous quality improvement and ensure work-life balance for our care team.
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
- Completion of a formal coding program (AHIMA, CCS, or AAPC preferred)
- Minimum of 3 years of applied coding experience or 5 years of OB/GYN coding experience
- Proficiency in ICD-10, CPT, medical terminology, anatomy, and health record content
- In-depth knowledge of Medicare, Medicaid, and managed care plans
- Understanding of HIPAA, Medicare Fraud and Abuse regulations, and EHR/Billing systems
- Proficiency in Microsoft Office and healthcare billing platforms
Preferred Qualifications
- Certified Professional Coder (CPC) certification
- Certified Coding Specialist (CCS) certification
