Senior Medical Coder & Billing Specialist Revenue Integrity

Planned-Parenthoo; New York (NY); On-site; USD 70,000 - 80,000; Full time

Benefits offered by this job

Generous PTO

Medical, dental and vision coverage

FSA/HSA

Disability and AD&D

401(k) with Safe Harbor

Job summary

Planned Parenthood of Greater New York (PPGNY) is seeking a Senior Coding and Billing Specialist to audit outpatient provider coding and education, ensuring accurate CPT/ICD-10-CM/HCPCS coding and compliant reimbursement. The role requires NY Medicaid knowledge and Epic EMR excellence, partnering with clinical and revenue cycle leaders to improve documentation quality and reduce denials.

The position emphasizes education, process improvement, and collaboration with providers and leadership to

Qualifications

• High school diploma or GED required.
• Five+ years outpatient provider coding experience with coder certification.
• Five+ years compliant provider documentation experience.
• Three+ years EPIC EMR coding, billing and documentation.
• Strong knowledge of CMS, Medicaid, and payer guidelines.
• Proficient with Microsoft Office (Excel, Pivot Tables, VLOOKUP).

Responsibilities

• Identify provider documentation improvement opportunities through coding audits and collaborate with providers and clinical leadership to enhance documentation quality and optimize reimbursement.
• Identify coding, billing, charge capture, and documentation issues impacting reimbursement and provide recommendations for corrective actions to the VP of Revenue Cycle.
• Identify coding-related payer denials and collaborate with appropriate stakeholders to reduce denials and improve coding accuracy.
• Maintain current knowledge of CPT, ICD-10-CM, HCPCS, CMS, New York State Medicaid, and commercial payer coding requirements and educate providers and staff in regulatory updates.
• Analyze trends in provider documentation, coding accuracy, and missed coding opportunities, and develop professional educational materials and recommendations for providers.
• Collaborate with third-party revenue cycle vendors to identify coding issues and opportunities and develop remediation plans.
• Recommend Epic automation, SmartSets, documentation templates, hard stops, soft stops, and workflow enhancements to improve coding accuracy, documentation compliance, and reimbursement.
• Perform other duties and special projects as assigned.

Skills

CPT/ICD-10-CM knowledge

Billing compliance

Regulatory knowledge

Communication skills

Microsoft Excel proficiency

Education

High school diploma/GED

Five+ years outpatient coding experience

Five+ years compliant provider documentation

Three+ years EPIC EMR coding/billing

Tools

EPIC EMR

Microsoft Office Suite

Job description

Planned Parenthood of Greater New York (PPGNY) is seeking a Senior Coding and Billing Specialist to audit outpatient provider coding and education, ensuring accurate CPT/ICD-10-CM/HCPCS coding and compliant reimbursement. The role requires NY Medicaid knowledge and Epic EMR excellence, partnering with clinical and revenue cycle leaders to improve documentation quality and reduce denials.

The position emphasizes education, process improvement, and collaboration with providers and leadership to