Picture yourself here: We are a team of trusted health care providers, educators, and fierce advocates committed to advancing equity and improving health outcomes in communities that face systemic barriers to quality, innovative sexual and reproductive health services -- including birth control, pregnancy testing, emergency contraception, cancer screenings, STI testing and treatment, HIV testing and prevention, transgender hormone therapy, wellness exams, crisis counseling, and financial counseling.

PPGNY also proudly provides compassionate, nonjudgmental abortion services. When you join PPGNY as a Medical Record Coding Auditor you will be responsible for This position will be responsible for performing on-going auditing of outpatient provider coding, and education. Individuals must be a certified coder, with experience in NY Medicaid regulations.

At Planned Parenthood of Greater New York (PPGNY), our greatest strengths are the employees who empower every individual with the information, resources, and care they need to live happy, healthy lives. Picture yourself here: We are a team of trusted health care providers, educators, and fierce advocates committed to advancing equity and improving health outcomes in communities that face systemic barriers to quality, innovative sexual and reproductive health services -- including birth control, pregnancy testing, emergency contraception, cancer screenings, STI testing and treatment, HIV testing and prevention, transgender hormone therapy, wellness exams, crisis counseling, and financial counseling. PPGNY also proudly provides compassionate, nonjudgmental abortion services.

DUTIES AND RESPONSIBILITIES

Revenue Cycle Coding (85%)

Responsible for performing coding and documentation audits to ensure compliance and optimal reimbursement.

Responsible for identifying billing and charge issues to Int VP Revenue Cycle, along with proposals on how to address them.

Identify Payer Coding Denials to work with appropriate stakeholders to reduce denials.

Maintain knowledge of CPT code changes and educate accordingly.

Validate trends of missed documentation and coding opportunities presenting a professional format for provider education.

Work with third party revenue cycle company to identify coding issues/ opportunities and develop remediation plans.

Evaluates the results of the periodic coding audits conducted by an outside agency, and partners with the VP of Revenue Cycle, Operations and clinical services leadership to provide training and feedback to the clinical providers on their performance and areas for improvement.

Based on coding and documentation needs, make EPIC automation and/or EPIC hard and soft stops and smart sets to assist with accurate and timely coding.

Various projects as assigned.

Training and Education (15%)

Develop on-going education for current providers and education on-boarding of new providers.

Responsible for identification of training needs for all registration areas and provide training material working in conjunction with Regional Director of Operations.

Responsible to keep abreast and maintain CMS billing rules and regulations to identify potential billing policy challenges.

Remain current on payer billing requirements.

CORE COMPETENCIES

A demonstrated commitment to PPGNY's mission related to bodily autonomy, health equity, gender and racial justice.

A demonstrated commitment to learning about and enhancing practices related to racial equity and its impact on healthcare systems.

Strong relationship building skills, including an ability to work and build trust across cultural differences related to race, age, gender, gender identity and expression, sexual orientation, religion, ethnicity, national origin or ability; and to reflect on one's personal identity with humility.

Customer service and interpersonal skills and the ability to coordinate work with others, both internally and externally, engages in mutual problem solving.

REQUIRED SKILLS/ABILITIES

Knowledge of Third-party payer contracts and Medicaid reimbursement

CPT4 ICD-10 coding requirements and compliance and all other carrier guidelines; strong knowledge of New York State Medicaid rules.

Ability to learn data and analytics techniques to ensure good decision making, performance measurement and financial analysis.

Strong time management skills, including the ability to work in a high distraction environment and to juggle multiple deliverables at one time.

Excellent interpersonal, written and verbal skills and the ability to explain complex coding regulations to individuals who are not subject matter experts.

Strong team building skills.

Proficient with Microsoft Office Suite, including Excel skills, such as macros, pivot table and v look up options.

Demonstrated ability to learn new systems.

Process improvement orientation.

Proven ability to remain focused and calm in stressful situations.

REQUIRED QUALIFICATIONS

Minimum Education and Work Experience

High school diploma/GED.

Five plus years' experience in outpatient provider coding, including coder certification.

Five plus years' experience in compliant provider documentation.

Three plus years' experience in healthcare billing.

PPGNY Medical Record Coding Auditor JD 02.26

Three plus years' experience in EPIC EMR coding, billing and provider documentation.

Strong knowledge and utilization of Microsoft Windows, Excel, Word, Power Point and Outlook.

PREFERED QUALIFICATIONS

Associate's degree in business.

Strong CMS Compliance knowledge and audit guidelines

TYPICAL PHYSICAL DEMANDS

Requires prolonged sitting and repetitive tasks including use of a computer. Periodic

standing, walking, bending. Requires lifting or moving of up to 15 pounds. Visual acuity

sufficient to perform frequent work on a computer screen and review printed reports and

other materials. Requires the ability to hear and to communicate orally with others. This

role routinely uses standard office equipment such as computers, phones, photocopiers,

and filing cabinets, and will require reaching, grasping, pushing, and pulling.

TYPICAL WORKING CONDITIONS

This job operates in a professional office environment. Potential exposure to

communicable diseases and other conditions in a health center environment. Requires

flexible schedule and during p

PPGNY's benefits package includes:

Generous PTO and holiday schedule

Medical, dental and vision coverage options for you and eligible dependents

FSA, HSA, Commuter pre-tax reimbursement funds

Short- and Long-Term Disability, Free Basic Life and AD&D

401(k) Retirement Plan with Safe Harbor contributions after 1 year of employment

All positions at PPGNY require:

Proof of immunization or immunity to certain communicable diseases (including influenza during the flu season and Covid-19) and testing for tuberculosis. These certifications are required by the NYC DOHMH Health Code, NYSDOH and OSHA.

Planned Parenthood of Greater New York (PPGNY) is a leading provider, educator, and advocate of sexual and reproductive health care in New York State. PPGNY is proud to provide a wide-range of family planning services at our brick-and-mortar health centers and mobile care units. We care for everyone regardless of their immigration status, zip code or ability to pay. PPGNY's education and outreach programs are backed by medically accurate, evidence-based information that allows people to make informed decisions about their health and future. As a voice for reproductive freedom, PPGNY supports legislation and policies that ensure all New Yorkers have access to the full range of reproductive health care and education.

At PPGNY, we provide the absolute best care to our patients and our communities through innovative health care delivery and education programming. We care for everyone who walks through our doors regardless of insurance, ability to pay or immigration status. As a leading voice for reproductive freedom, PPGNY fiercely advocates for policies to ensure that all New Yorkers will have access to the full range of reproductive health care services and information.

PPGNY is committed to diversity, equity, and inclusion. We believe we are most impactful when people with a wide range of backgrounds, experiences, and identities come together with common purpose. We encourage candidates from all backgrounds to apply.

Planned Parenthood of Greater New York

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