Billing and Coding Specialist (Contract)

About Diana Health 

Diana Health is a high-growth network of modern women's health practices.  We are on a mission to set a new standard of care that inspires, empowers, and supports women to live healthier, more fulfilling lives. We partner directly with hospitals and align incentives across stakeholders using integrated care teams, smart technology, and a designed care experience that is good for patients and good for providers. The result is an individualized, comprehensive care program that puts women in the driver’s seat of their own health and provides them with the information and compassionate care they need to reach their health goals.  

We are an interdisciplinary team joined together by our shared commitment to transform women’s health.  Come join us!

Description:

We are looking for a Billing and Coding Specialist to review claims data to ensure the assigned procedural and diagnosis codes meet required legal and standardized insurance rules

What you’ll do: 

• Validates charges and documentation to ensure billing codes are accurate prior to claims submission. Seeks clarification from provider and/or clinical staff as needed.
• Applies coding (CPT, HCPCS, and ICD-10) and modifiers accurately and appropriately.
• Applies payer specific coding requirements as appropriate.
• Codes for all services performed. Services may include office visits, wellness exams, in office surgeries & procedures, injections, supplies, lab, ultrasound, behavioral health, inpatient and outpatient hospital services, birth center, and ambulatory surgical center.
• Assists with prior authorization coding and accounts receivable coding denial reviews.
• Adds account notes when a claim has been changed or reviewed.
• Provides feedback to coding or auditing supervisor if there are trends in coding errors.
• Attends job related in-service education programs.
• Participates in continuing education programs to increase coding knowledge.
• Mentors and trains other coders within the department as needed.
• Maintains accuracy and productivity in accordance with Diana Health’s Coding Standards.
• Understands the Athena billing and coding and related modules, including patient registration and guarantor snapshot.

Qualifications

• High school diploma or GED required
• Coding certification through AAPC or AHIMA required. CPC preferred
• At least three years of experience in medical coding required and two years of experience with OBGYN/MFM coding preferred
• Knowledge of medical terminology and coding, including, ICD-10, CPT and HCPCS required. OB/GYN specific knowledge preferred
• Experience in Athena is preferred
• Demonstrated ability to be detail oriented with strong aptitude for accuracy required
• Demonstrated ability to effectively work with others required
• Knowledge of local and major national medical insurance practices preferred
• Knowledge of proper business writing standards for letters and memos including the ability to write a correspondence with proper punctuation, grammar, spelling, etc
• Proven effective verbal, listening and written communications skills

Benefits

• Competitive compensation

Diana Health Culture

• Having a growth mindset and striving for continuous learning and improvement
• Positive, can do / how can I help attitude
• Empathy for our team and our clients
• Taking ownership and driving to results
• Being scrappy and resourceful