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.
Coder - Team Lead
Location
United States
Posted
16 days ago
Salary
Not specified
No structured requirement data.
Job Description
Job Requirements
- Active coding certification required (CPC, CCS, CCS-P, or equivalent).
- Minimum of five (5) years of professional medical coding experience, in OB/GYN within a physician billing or revenue cycle environment.
- Prior experience in a lead, audit, quality assurance, or mentoring role preferred.
- Advanced knowledge of ICD-10-CM, CPT, and HCPCS coding guidelines, including specialty-specific rules for OB/GYN.
- Thorough knowledge of CMS, Medicaid, and commercial payer requirements, including fraud and abuse regulations.
- Strong working knowledge of Electronic Health Records (EHR) and physician billing systems.
- Full knowledge of HIPAA regulations and confidentiality standards.
- Demonstrated leadership, coaching, and communication skills.
- Reviews and validates professional coding for OB/GYN and behavioral health services prior to charge entry or approval.
- Ensures accurate assignment of diagnosis and procedure codes, modifiers, and units in compliance with CMS, OIG, and payer guidelines.
- Provides routine coding audits and quality reviews; provides targeted feedback and education based on findings.
- Identifies documentation gaps, denial trends, and compliance risks and recommends corrective actions.
- Appropriately queries providers for missing, conflicting, or unclear documentation.
- Reviews and resolves coding-related claim rejections and denials.
- Ensures all services meet medical necessity and documentation requirements prior to billing.
- Coordinates with AR, billing, CDI, and revenue cycle teams to support timely claim resolution.
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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