The Certified OB/GYN Medical Coder is responsible for reviewing clinical documentation and accurately assigning diagnosis and procedure codes for obstetric and gynecologic services. This role ensures coding is completed accurately, efficiently, and in compliance with current coding standards, payer requirements, and regulatory guidelines.
The ideal candidate has strong knowledge of OB/GYN coding, including maternity and global obstetrical services, and is comfortable interpreting medical records, identifying documentation gaps, and collaborating with providers and revenue cycle teams. This position plays an important role in supporting accurate reimbursement, minimizing coding-related denials, and maintaining revenue integrity.
Key Responsibilities
- Review and analyze medical records to accurately assign ICD-10-CM, CPT, HCPCS Level II, and appropriate modifier codes.
- Code a variety of OB/GYN services, including:
- Routine prenatal visits
- Global maternity care
- Vaginal and cesarean deliveries
- Postpartum care
- Gynecologic office visits
- Surgical procedures
- Preventive services
- Family planning services
- Ultrasound and diagnostic testing
- Apply current coding guidelines and specialty-specific requirements to ensure accurate and compliant coding.
- Review provider documentation for completeness, specificity, medical necessity, and coding support.
- Identify documentation deficiencies and submit appropriate provider queries when clarification is needed.
- Ensure coding aligns with CMS, commercial payer, and organizational requirements.
- Review billing edits, coding-related denials, and payer trends to identify recurring issues and opportunities for improvement.
- Assist with coding-related denial resolution and appeals.
- Maintain established productivity, quality, and accuracy standards.
- Participate in coding audits, quality reviews, and education initiatives.
- Stay current with ICD-10-CM, CPT, HCPCS, modifier, payer, and OB/GYN coding updates.
- Collaborate with providers, clinical staff, billing teams, and revenue cycle leadership to improve documentation and reimbursement processes.
- Maintain patient confidentiality and comply with HIPAA and applicable privacy regulations.
- Perform other coding and revenue cycle-related duties as assigned.
Qualifications
- High school diploma or equivalent required.
- Minimum of 2 years of professional medical coding experience.
- At least 1 year of OB/GYN coding experience preferred.
- Experience working with electronic health records and practice management systems.
- Experience coding for a multi-provider OB/GYN practice.
- Strong knowledge of global obstetrical and maternity coding.
- Experience with coding-related denials, appeals, and revenue cycle processes.
- Experience with Epic or other healthcare information systems.
- Experience interpreting operative reports and complex clinical documentation.
- Advanced knowledge of ICD-10-CM, CPT, and HCPCS coding systems.
- Strong understanding of OB/GYN anatomy, physiology, procedures, and medical terminology.
- Knowledge of payer-specific coding, billing, and reimbursement requirements.
- Ability to accurately interpret clinical documentation and operative reports.
- Strong analytical and problem-solving skills.
- Exceptional attention to detail and accuracy.
- Strong written and verbal communication skills.
- Ability to manage multiple priorities while meeting productivity and turnaround-time requirements.
- Proficiency with Microsoft Office applications, particularly Outlook, Word, and Excel.
- Ability to work independently while collaborating effectively with providers and revenue cycle teams.
- Amenable to work during US hours
- Must be willing to undergo a background check as part of the hiring process.
Perks
- Permanent Work From Home
- Leave Credits
- Monetary Allowance
- Annual Bonus
- Weekly PaychecksFixed Weekends Off
- Thriving Company Culture with Complete Autonomy
- Exclusive Specialized Training Programs
- Unlock Your Potential with a Highly Competitive Salary
Who are we?
BizForce is one of the fastest-growing global outsourcing companies in the world, founded in the US in Tucson, Arizona and is now operational in PH!
Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.