Benefits:- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Paid time off
- Profit sharing
- Vision insurance
Benefits/Perks- Competitive Compensation
- Great Work Environment
- Career Advancement Opportunities
Job SummaryEvery Woman’s OB/GYN is seeking a knowledgeable, detail-oriented, and dependable
Medical Biller & Coder to join our team.
The ideal candidate will have experience in medical billing and coding, preferably within an OB/GYN or women’s healthcare setting. This individual will be responsible for accurate claim submission, insurance follow-up, payment posting, denial resolution, and maintaining timely reimbursement for services provided.
The Medical Biller & Coder must demonstrate strong organizational skills, excellent communication, and the ability to work independently while collaborating with providers, clinical staff, and administrative leadership.
Responsibilities - Medical Billing & Coding
- Review and accurately code OB/GYN encounters using ICD-10-CM, CPT, and HCPCS codes.
- Process and submit clean claims to commercial insurance, Medicare, and Medicaid.
- Ensure proper billing for prenatal care, deliveries, postpartum visits, gynecological procedures, ultrasounds, and office visits.
- Understand global maternity billing, including antepartum, delivery, and postpartum services.
- Review provider documentation to ensure coding accuracy and compliance.
- Identify and correct coding errors, claim rejections, and billing discrepancies.
- Maintain compliance with HIPAA, payer policies, and applicable billing regulations.
- Insurance Claims & Accounts Receivable
- Monitor outstanding insurance claims and accounts receivable (A/R).
- Follow up on unpaid, denied, rejected, and underpaid claims.
- Submit corrected claims, reconsiderations, and appeals when necessary.
- Review insurance explanations of benefits (EOBs) and electronic remittance advice (ERAs).
- Post insurance payments, adjustments, and patient payments accurately.
- Investigate payment discrepancies and coordinate resolution with insurance carriers.
- Maintain timely follow-up on aging accounts to reduce outstanding balances.
- OB/GYN-Specific Billing
- Demonstrate understanding of maternity global packages and payer-specific billing requirements.
- Process claims for routine gynecological visits, preventive services, and problem-oriented visits.
- Understand appropriate billing for ultrasounds, contraceptive services, minor procedures, and surgical services.
- Verify proper use of modifiers, diagnosis codes, and procedure codes.
- Assist with insurance-related questions involving prenatal care, maternity benefits, and patient financial responsibility.
- Coordinate with providers when documentation clarification is needed.
- Patient Accounts & Communication
- Review patient account balances and identify outstanding financial obligations.
- Assist with patient billing questions and insurance concerns.
- Communicate professionally with insurance companies, patients, and internal staff.
- Coordinate with the front desk regarding outstanding balances, payment arrangements, and insurance updates.
- Maintain accurate documentation of billing activities and account follow-up.
- Reporting & Revenue Cycle Management
- Review aging reports and prioritize accounts requiring follow-up.
- Monitor claim denials, payment trends, and reimbursement delays.
- Provide regular updates to management regarding outstanding claims and collection concerns.
- Identify opportunities to improve billing accuracy, collections, and overall revenue cycle performance.
- Maintain organized records of claims, appeals, payments, and insurance correspondence.
Qualifications- Required Qualifications
- Minimum 2 years of medical billing and coding experience.
- Working knowledge of ICD-10-CM, CPT, and HCPCS coding.
- Experience with insurance claim submission, denial management, and A/R follow-up.
- Knowledge of commercial insurance, Medicare, and Medicaid billing requirements.
- Familiarity with electronic medical records (EMR/EHR) and practice management systems.
- Strong attention to detail and ability to maintain accurate records.
- Excellent written and verbal communication skills.
- Ability to prioritize responsibilities and meet deadlines.
- Understanding of HIPAA and patient confidentiality requirements.
- Preferred Qualifications
- Previous OB/GYN or women’s healthcare billing experience strongly preferred.
- Experience with global maternity billing and gynecological procedure coding.
- Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) preferred.
- Experience with claim appeals, payer portals, and insurance reimbursement analysis.
- Familiarity with Georgia Medicaid and managed care insurance plans.
- Experience preparing billing reports and tracking accounts receivable.
- Ability to work independently with minimal supervision.
- Ideal Candidate
We are looking for someone who is proactive, accountable, organized, and committed to maintaining an efficient billing department. The successful candidate will take ownership of assigned accounts, consistently follow up on outstanding claims, communicate effectively with management, and help maximize timely and accurate reimbursement.