Medical Biller / Coder (OB/GYN Specialist)

Paycom; Doylestown (Bucks County); On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Competitive Salary

100% Employer-Paid Health Insurance

Paid Vision Insurance

Paid Dental Insurance

401(k) Retirement Plan with Company 匹

Paid Time Off (PTO) and Paid Holidays

Job summary

Doylestown Womens Health Center seeks a detail-oriented OB/GYN Medical Biller and Coder to manage patient accounts and translate clinical documentation into accurate codes. The role focuses on the 2027 transition from global OB codes to phase-specific maternity coding.

Required CPC certification, 2+ years of OB/GYN billing, and strong EHR/PM system skills; AthenaNet experience is highly preferred to expedite onboarding.

Qualifications

• CPC certification is required.
• Minimum 2 years in medical billing; at least 1 year in OB/GYN.
• Deep knowledge of CPT 2027 Maternity Care changes.
• Experience with Athenahealth or similar EHR/PM systems is preferred.

Responsibilities

• Lead the 2027 transition from global OB codes to phase-specific reporting (Antepartum, Labor, Delivery, Postpartum).
• Apply correct E/M coding for prenatal and postpartum visits based on MDM or time.
• Use new labor management codes and distinguish from delivery-only codes.
• Apply maternity-specific and multi-procedure modifiers (e.g., 25, 59, 51) as needed.
• Research and resolve claims in the practice management system; audit documentation for compliance.

Skills

CPC Certification

OB/GYN Billing Experience

AthenaNet Experience

EHR/PM Software

Education

High School or Equivalent

Tools

AthenaNet (Athenahealth)

Job description

Job Details: Level: Entry, Job Location: Doylestown Womens Health Center - Doylestown, PA, Position Type: Full Time, Education Level: High School or Equivalent, Salary Range: Undisclosed, Travel Percentage: None, Job Shift: Day, Job Category: Health Care, Job Summary

We are seeking a detail-oriented, certified OB/GYN Medical Biller and Coder to join our healthcare team. In this role, you will manage the complete lifecycle of patient accounts, translating complex obstetrics and gynecology clinical documentation into accurate codes. A major focus of this role will be preparing for and executing the massive shift from traditional global OB bundled codes to the new, service-level itemized maternity framework going into effect January 1, 2027. Experience navigating Athenahealth workflows is a significant advantage.

Key Responsibilities

• 2027 Guidelines Transition: Lead the practice's billing transition by identifying and executing the elimination of traditional global OB codes, shifting entirely to phase-specific reporting (Antepartum, Labor Management, Delivery, and Postpartum).
• E/M-Based Prenatal & Postpartum Billing: Apply proper Evaluation and Management (E/M) coding rules based on Medical Decision Making (MDM) or time for all individual antepartum and postpartum visits.
• Labor Management & Delivery Separation: Accurately utilize the new, dedicated daily labor management codes (including distinctions between straightforward and complex care) and report them separately from simplified delivery-only surgical codes.
• Modifier Management: Apply specialty-specific modifiers correctly (e.g., maternity-specific modifiers and multi-procedure modifiers like 25, 59, 51) to justify multi-procedure encounters and maximize optimal reimbursement.
• Claims & Workflow Resolution: Research and resolve claims caught in practice management rules engines, proactively auditing clinical documentation to ensure compliance with the new itemized coding volume.
• Denials, Appeals & A/R: Investigate denied claims, submit clear appeals through insurance portals, and systematically work accounts receivable (A/R) worklists to reduce days in A/R.
• Provider Education: Collaborate closely with OB/GYN physicians and midwives to align their documentation habits with the stricter criteria required by the 2027 maternity care guidelines.

Required Qualifications & Skills

• Certification: Active Certified Professional Coder (CPC®) credential via AAPC.
• Specialty Experience: Minimum of 2 years of dedicated medical billing experience, with at least 1 year heavily focused on an OB/GYN practice environment.
• Technical Mastery: In-depth, forward-looking knowledge of the 2027 CPT® Maternity Care code changes (including the deletion of global codes like 59400, the addition of distinct phase-specific codes, and new same-day reporting rules).
• Software Familiarity: Experience with electronic health records (EHR) and practice management software. Hands-on experience with Athenahealth (AthenaNet) is highly preferred and helpful to accelerate onboarding.
• Soft Skills: Outstanding analytical thinking, precise attention to detail, and a highly professional communication style for sensitive insurance and patient interactions.

Benefits

• Competitive Salary
• 100% Employer-Paid Health Insurance
• Paid Vision Insurance
• Paid Dental Insurance
• 401(k) Retirement Plan with Company Match
• Paid Time Off (PTO) and Paid Holidays

Qualifications

Qualifications: Certification Required: Certified Professional Coder (CPC®)

Platform Experience: Athenahealth (AthenaNet) experience is highly preferred and considered helpful but not required.

Regulatory Focus: Mastery of the CPT® 2027 Maternity Care Services Overhaul (effective 1/1/2027) is strictly required.

Compensation: Competitive salary, commensurate with experience and credentials.