Medical Biller/ Coder (OB/GYN coder)

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

• Education & Experience:
• 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.
• Licensure/Certification:
• 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.
• Key Skills
• 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.
• Why Join Diana Health
• At Diana Health, we believe in advancing women's healthcare through compassion, integrity, and innovation. As a member of our Revenue Cycle team, you'll play a vital role in ensuring the accuracy and integrity of our financial operations while supporting patient-centered care.

Benefits

Additional Information

About Diana Health 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 are restructuring the traditional approach to care to create an experience that is good for patients and good for providers. We do that by combining a tech-enabled, wellness-focused care program that women love with a clinical system that helps us drive continuous quality improvement and ensure work-life balance for our care team. We work with clients across all life stages to empower and support them to live happier, healthier, more fulfilling lives. With strong collaborative care teams; passionate administrators and a significant investment in operational support, Diana Health employees are well-supported to bring their very best to the work they love. Come join us! Role Description Diana Health is seeking a skilled and detail-oriented Medical Biller / Coder to join our Revenue Cycle team. In this role, you'll ensure the accurate coding of medical procedures and diagnoses across our diverse range of services including inpatient, outpatient, ambulatory, and specialty care. You'll play a key role in supporting compliance, optimizing reimbursements, and ensuring all documentation aligns with federal and state regulations.

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