Medical Coder (Healthplus IVF)

Overview

We are seeking a highly accurate and dependable Medical Coder to join our team at HealthPlus IVF. This role ensures that all patient encounters, procedures, and diagnostic services are coded accurately and fully compliant with DOH and payer requirements. The Medical Coder plays a pivotal role in maintaining financial transparency, supporting timely reimbursements, and upholding data accuracy for regulatory reporting and quality benchmarking.

Responsibilities

• Accurately code and map clinical procedures, diagnoses, and services using approved classification systems.
• Assign approval codes and link services to eligibility data and treatment cycles through EMR systems such as Meditex and OpenJet.
• Review documentation completeness across IVF, obstetrics, and women’s health services to ensure alignment with DOH and payer criteria.
• Conduct pre-submission coding audits (minimum 5% sampling) to ensure compliance and prevent claim rejections.
• Identify documentation gaps and coordinate with physicians, nurses, and embryologists to resolve discrepancies.
• Manage claim resubmissions and correction workflows with justifications and audit trails.
• Ensure accuracy of post-procedure approvals and coding consistency with performed services.
• Support internal and external audits (Tasneef, DOH, payers) through accurate documentation, reporting, and data integrity maintenance.
• Participate in training and continuous education programs to stay updated on regulatory and coding changes.
• Contribute to RCM efficiency by collaborating with billing and insurance teams to optimize revenue capture and reduce denials.
  
  

Qualifications

• Bachelor’s Degree in Medical Coding, Health Information Management, or a related discipline.
• Certified Professional Coder (CPC, CCA, CCS, or equivalent) certification required.
• 2–5 years of coding experience within IVF, obstetrics/gynecology, or other regulated healthcare specialties.
• Strong understanding of DOH regulations, payer policies, and audit frameworks.
• Experience using EMR and RCM platforms (Meditex, OpenJet) and online payer systems.
• Excellent analytical and problem-solving skills, with strong documentation accuracy.
• Knowledge of ADHICS data protection and information governance principles preferred.