Medical Coder

At Planned Parenthood of Greater New York (PPGNY), we empower individuals with information, resources, and care to live happy, healthy lives. We are a trusted team of health care providers, educators, and advocates committed to advancing equity and improving health outcomes in communities facing systemic barriers to quality sexual and reproductive health services, including birth control, pregnancy testing, emergency contraception, cancer screenings, STI testing and treatment, HIV testing and prevention, transgender hormone therapy, wellness exams, crisis counseling, and financial counseling. We also provide compassionate, nonjudgmental abortion services.

As a Medical Record Coding Auditor / Medical Coder, you will perform on-going auditing of outpatient provider coding and education. This role requires a certified coder with experience in NY Medicaid regulations.

Duties and Responsibilities:

• Perform coding and documentation audits to ensure compliance and optimal reimbursement
• Identify billing and charge issues and propose solutions
• Identify payer coding denials and collaborate to reduce denials
• Stay updated on CPT code changes and provide education
• Validate trends of missed documentation and coding opportunities and provide professional provider education
• Work with third-party revenue cycle companies to identify coding issues/opportunities and develop remediation plans
• Evaluate results from periodic coding audits by outside agencies and provide training and feedback to clinical providers
• Implement EPIC EMR automation and smart sets to assist with accurate and timely coding
• Develop ongoing education for current and new providers
• Identify training needs and provide training materials
• Maintain up-to-date knowledge of CMS billing rules and payer requirements

Core Competencies:

• Commitment to PPGNY’s mission related to bodily autonomy, health equity, gender and racial justice
• Dedication to learning and improving racial equity practices impacting healthcare
• Strong relationship building and interpersonal skills
• Ability to coordinate work and engage in problem-solving

Required Skills and Abilities:

• Knowledge of third-party payer contracts and Medicaid reimbursement
• CPT4, ICD-10 coding expertise and compliance, NY State Medicaid rules
• Data analytics skills for decision making and financial analysis
• Strong time management and multi-tasking abilities
• Excellent communication to explain coding regulations to non-experts
• Strong team building skills
• Proficient with Microsoft Office Suite including advanced Excel skills
• Ability to quickly learn new systems and focus under pressure

Required Qualifications:

• High school diploma/GED
• Minimum 5 years outpatient provider coding experience including certification
• Minimum 5 years compliant provider documentation experience
• Minimum 3 years healthcare billing experience
• Minimum 3 years EPIC EMR coding and billing experience

Preferred Qualifications:

• Associate degree in business
• Strong CMS compliance knowledge and audit guidelines

Physical Demands:

• Prolonged sitting and repetitive computer tasks
• Occasional standing, walking, bending
• Lifting/moving up to 15 pounds
• Visual acuity for computer and printed materials
• Ability to hear and communicate orally

Working Conditions:

• Professional office environment with potential exposure to communicable diseases
• Flexible schedule requirements

Benefits:

• Generous PTO and holidays
• Medical, dental, and vision coverage options for employees and dependents
• FSA, HSA, commuter pre-tax reimbursement funds
• Short- and long-term disability, free basic life and AD&D insurance
• 401(k) plan with safe harbor contributions after 1 year

Additional Information:

• Proof of immunization/immunity and tuberculosis testing required as per NYC and NYS health codes

PPGNY is a leading provider and advocate in sexual and reproductive healthcare in New York, serving all individuals regardless of immigration status, zip code, or ability to pay. We are committed to diversity, equity, and inclusion and encourage candidates from all backgrounds to apply.

Salary range is based on the New York market and may vary based on job related factors and location.