Medical Claim Coding Analyst / Medical Coder

Unified Women's Healthcare is a nationwide community of providers and specialists dedicated to improving women's health through extensive clinical services including telehealth and targeted case management. The Revenue Cycle Management (RCM) team is seeking experienced professionals for a talent pipeline of multiple current and upcoming coding roles.

There are two primary roles available:

• Coding Analyst: Responsible for reviewing, auditing, and coding provider documentation for reimbursement, training, education, and compliance using ICD-10 and CPT codes. This role includes analyzing pre-bill claim edits, claim denials, and accounts receivable management. It involves assisting with proactive audits for compliance with federal coding regulations, providing second-level reviews, and modifying client procedures to maintain compliance.

• Medical Coder: Provides coding services on inpatient, outpatient, or physician medical records using ICD-10 coding for accurate billing. The role involves denial management, proactive audits for federal compliance, second-level reviews of assigned codes, and updating client protocols to ensure billing compliance.

Shared responsibilities:

• Perform second-level reviews to ensure compliance and optimal reimbursements while preventing unbundling and questionable practices.
• Audit medical records to identify miscoding, prepare findings reports, and provide education to providers.
• Interact with physicians and care providers to clarify billing and documentation.
• Coordinate with Revenue Specialists and billing staff for AR management, corrections, and resubmissions.
• Analyze payor fee schedule performance and trends.
• Research and respond to compliance inquiries, policy changes, and denials.
• Provide training and guidance on coding compliance and documentation.
• Maintain confidentiality of financial and medical records.

Qualifications include a Certified Professional Coder (CPC) certification, a minimum of 5 years' relevant experience (billing, coding, or related support), preferred associate degree, and OB/GYN experience preferred but not required. Strong knowledge of auditing principles, medical coding systems, legal/regulatory compliance, and excellent communication skills are necessary. Ability to travel up to 25% is required.

Benefits include medical, dental, vision, fertility, paid time off, 401(k) with employer contribution, income protection, wellbeing support, and professional development opportunities.