Medical Coder

BrooklynRemotePart Timemid

Medical CoderHealthcare Non-Clinical

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Overview

At Planned Parenthood of Greater New York (PPGNY), our greatest strengths are the employees who empower every individual with the information, resources, and care they need to live happy,

Technical Tools

Medical CoderHealthcare Non-Clinical

Picture yourself here: We are a team of trusted health care providers, educators, and fierce advocates committed to advancing equity and improving health outcomes in communities that face systemic barriers to quality, innovative 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.

PPGNY also proudly provides compassionate, nonjudgmental abortion services. When you join PPGNY as a Medical Record Coding Auditor you will be responsible for This position will be responsible for performing on-going auditing of outpatient provider coding, and education. Individuals must be a certified coder, with experience in NY Medicaid regulations.

At Planned Parenthood of Greater New York (PPGNY), our greatest strengths are the employees who empower every individual with the information, resources, and care they need to live happy, healthy lives. Picture yourself here: We are a team of trusted health care providers, educators, and fierce advocates committed to advancing equity and improving health outcomes in communities that face systemic barriers to quality, innovative 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. PPGNY also proudly provides compassionate, nonjudgmental abortion services.

Revenue Cycle Coding (85%)

Responsible for performing coding and documentation audits to ensure compliance and optimal reimbursement.

Responsible for identifying billing and charge issues to Int VP Revenue Cycle, along with proposals on how to address them.

Identify Payer Coding Denials to work with appropriate stakeholders to reduce denials.

Maintain knowledge of CPT code changes and educate accordingly.

Validate trends of missed documentation and coding opportunities presenting a professional format for provider education.

Work with third party revenue cycle company to identify coding issues/ opportunities and develop remediation plans.

Evaluates the results of the periodic coding audits conducted by an outside agency, and partners with the VP of Revenue Cycle, Operations and clinical services leadership to provide training and feedback to the clinical providers on their performance and areas for improvement.

Based on coding and documentation needs, make EPIC automation and/or EPIC hard and soft stops and smart sets to assist with accurate and timely coding.

Various projects as assigned.

Training and Education (15%)

Develop on-going education for current providers and education on-boarding of new providers.

Responsible for identification of training needs for all registration areas and provide training material working in conjunction with Regional Director of Operations.

Responsible to keep abreast and maintain CMS billing rules and regulations to identify potential billing policy challenges.

Remain current on payer billing requirements.

A demonstrated commitment to PPGNY’s mission related to bodily autonomy, health equity, gender and racial justice.

A demonstrated commitment to learning about and enhancing practices related to racial equity and its impact on healthcare systems.

Strong relationship building skills, including an ability to work and build trust across cultural differences related to race, age, gender, gender identity and expression, sexual orientation, religion, ethnicity, national origin or ability; and to reflect on one’s personal identity with humility.

Customer service and interpersonal skills and the ability to coordinate work with others, both internally and externally, engages in mutual problem solving.

Knowledge of Third-party payer contracts and Medicaid reimbursement

CPT4 ICD-10 coding requirements and compliance and all other carrier guidelines; strong knowledge of New York State Medicaid rules.

Ability to learn data and analytics techniques to ensure good decision making, performance measurement and financial analysis.

Strong time management skills, including the ability to work in a high distraction environment and to juggle multiple deliverables at one time.

Excellent interpersonal, written and verbal skills and the ability to explain complex coding regulations to individuals who are not subject matter experts.

Strong team building skills.

Proficient with Microsoft Office Suite, including Excel skills, such as macros, pivot table and v look up options.

Demonstrated ability to learn new systems.

Process improvement orientation.

Proven ability to remain focused and calm in stressful situations.

Minimum Education and Work Experience

High school diploma/GED.

Five plus years’ experience in outpatient provider coding, including coder certification.

Five plus years’ experience in compliant provider documentation.

Three plus years’ experience in healthcare billing.

PPGNY Medical Record Coding Auditor JD 02.26

Three plus years’ experience in EPIC EMR coding, billing and provider documentation.