Coding Analyst - Temp Role

Unified Women's Healthcare•UNAVAILABLE, Florida

22h

About The Position

Unified Women’s Healthcare is dedicated to supporting OB/GYN providers and their staff by providing business knowledge, innovation, and operational support. The Coding Analyst reviews, audits, and codes provider documentation using ICD-10 and CPT codes for reimbursement, training, education, and compliance. The position serves as an information resource for providers, clinical staff, practice managers, Revenue Cycle team members, and leadership. The role analyzes pre-bill claim edits, claim denials, and accounts receivable management. In collaboration with Revenue Specialists, the Coding Analyst reviews and amends denied claims to ensure accurate coding and compliance with payor policies. The analyst also assists the Revenue Cycle Manager with proactive medical-record audits, conducts second-level reviews of assigned codes, and reviews or modifies procedures, systems, and protocols to meet billing requirements and compliance standards. This is a temporary role.

Requirements

Certified Professional Coder (CPC) certification.
At least 5 years of experience as a biller, collector, coder, back-office support staff member, or in equivalent medical industry work.
Knowledge of auditing concepts and principles.
Advanced knowledge of medical coding and billing systems and regulatory requirements.
Ability to use independent judgment and manage and impart confidential information.
Ability to analyze and solve problems.
Ability to travel up to 25% as needed.
Strong communication and interpersonal skills.
Knowledge of legal, regulatory, and policy compliance issues related to medical coding, billing procedures, and documentation.
Knowledge of current and developing issues and trends in medical coding procedure requirements.

Nice To Haves

OB/GYN experience.
Associate degree from an accredited university.

Responsibilities

Provide second-level review of billing performance to ensure compliance with legal and procedural policies, support optimal reimbursement, and avoid unbundling or other questionable practices.
Audit medical record documentation for under-coded and over-coded services, prepare findings reports, and educate providers on accurate coding and compliance.
Communicate with physicians and other care providers about billing and documentation policies, procedures, and regulations; query providers to clarify conflicting, ambiguous, or non-specific documentation.
Report documentation issues or trends to the Revenue Cycle Manager and/or practice administrator.
Work with Revenue Specialists and practice billing specialists on patient-account follow-up and accounts receivable management, including claim corrections and resubmissions.
Analyze payor performance, fee schedule reimbursements, and related trends.
Research, analyze, and respond to inquiries about compliance, payor policies and guidelines, inappropriate coding, denials, and billable services.
Monitor and distribute communications about payor policy changes and updates relevant to provider specialties.
Provide training, guidance, and oversight to staff with less coding experience.
Serve as a coding information resource and subject matter expert, and encourage clinicians to improve coding behaviors.
Train and support medical providers and practice billing specialists on coding compliance, documentation, regulations, and third-party payor requirements.
Review, develop, modify, and adapt client procedures, protocols, and data management systems to ensure compliance with organizational policies.
Work with providers and management to review or implement codes and update charge documents.
Maintain knowledge of healthcare revenue cycle operations, coding, claims, and state insurance laws.
Protect the confidentiality of financial and medical records.
Perform other job-related duties as assigned.