Accounts Receivable, Certified Professional Coder

Columbia University; New York (NY); On-site; USD 65,000 - 75,000; Full time

Job summary

An established industry player is seeking a Certified Professional Coder to ensure accurate medical coding and compliance within their Clinical Revenue Office. This role is crucial for maintaining high standards in billing and reimbursement processes, supporting denial resolution, and enhancing revenue cycle operations. The ideal candidate will possess a Bachelor's degree, CPC certification, and a strong background in medical coding. Join a dynamic team that values continuous improvement and compliance, while enjoying a flexible work environment with occasional in-office meetings. This is a fantastic opportunity to make a significant impact in a vital healthcare role.

Qualifications

• 3+ years of medical coding experience, preferably in a physician billing environment.
• CPC certification required with proficiency in coding standards.

Responsibilities

• Accurate coding of medical records and claims within the Clinical Revenue Office.
• Research claim denials and manage complex coding-related cases.

Skills

Medical Coding

CPT Coding

ICD-10 Coding

HCPCS Coding

Insurance Verification

Attention to Detail

Organizational Skills

Communication Skills

Problem Solving

Education

Bachelor's Degree

CPC Certification

Tools

Epic

Microsoft Office

Job description

Job Type: Officer of Administration
Regular/Temporary: Regular
Hours Per Week: 35
Standard Work Schedule: 9AM-5PM, M-F
Salary Range: $65,000.00-$75,000.00

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to departmental budgets, qualifications, experience, education, licenses, specialty, and training. The above hiring range represents the University's good faith and reasonable estimate of the range of possible compensation at the time of posting.

Position Summary

The Certified Professional Coder (CPC) is responsible for accurate coding of medical records and claims within the Clinical Revenue Office's Accounts Receivable department. This role ensures compliance with payer regulations, supports denial resolution, and contributes to efficient revenue cycle operations. The CPC plays a vital role in ensuring proper billing and reimbursement while maintaining high standards of compliance and accuracy.

Responsibilities

Accounts Receivable Coding

• Research root causes of claim denials and apply knowledge of payer policies to determine the appropriate course of action, including appeals.
• Manages complex coding-related cases and recommends resolutions while escalating issues when necessary.
• Prepares and reviews correspondence with insurance companies, patients, or guarantors to address claim-related inquiries.
• Documents all actions and findings in the billing system to maintain accurate and comprehensive account records.
• Collaborates with senior leadership to address unresolved or escalated issues.

Coding and Charge Review

• Reviews charges in work queues for compliance and accuracy, ensuring alignment with Current Procedural Terminology (CPT), ICD-10, and other coding standards.
• Performs reconciliation of charges against appointment reports or procedure logs to ensure all patient services are billed appropriately.
• Verifies the accuracy of charge header information, including service provider, billing area, CPT codes, modifiers, and diagnosis linkage.
• Communicates with providers to resolve discrepancies via Epic or a secure chat.
• Reviews charge correction requests and ensures accuracy prior to resubmission.

Denials Management

• Collaborates with Accounts Receivable staff to resolve denied or rejected claims related to coding issues.
• Provides expertise in payer-specific coding requirements to facilitate successful appeals and payment recovery.
• Tracks trends in denials and recommends process improvements to reduce future errors.

Insurance Verification and Compliance

• Conducts thorough insurance verification to ensure accurate claim submission and timely reimbursement.
• Updates patient accounts with corrected demographic or insurance information as necessary.
• Ensures compliance with organizational and regulatory coding standards, including HIPAA and Medicare/Medicaid guidelines.

Continuous Improvement

• Monitors key performance indicators and participates in performance improvement initiatives.
• Provides coding expertise to support department goals and enhance revenue cycle operations.

Compliance & Other

• Performs other tasks and assumes additional responsibilities within the Revenue Cycle Department as assigned.
• Represents the FPO Clinical Revenue Office on cross-functional committees, task forces, and work groups as assigned.
• Conforms to all applicable HIPAA, Billing Compliance, and safety policies and guidelines.

Please note: While this position is primarily remote, candidates must be in a Columbia University-approved telework state. There may be occasional requirements to visit the office for meetings or other business needs. Travel and accommodation costs associated with these visits will be the responsibility of the employee and will not be reimbursed by the company.

Minimum Qualifications

• Bachelor's Degree or an equivalent combination of education and experience.
• A minimum of 3 years of medical coding experience, preferably in a physician billing or third-party payer environment.
• An equivalent combination of education and experience may be considered.
• CPC certification is required.
• Proficiency in CPT, ICD-10, and HCPCS coding, as well as payer-specific billing guidelines.
• Strong working knowledge of managed care eligibility, referrals, and authorizations.
• Demonstrated ability to interpret clinical documentation and ensure compliance with coding and billing standards.
• Excellent organizational skills and attention to detail with the ability to handle multiple tasks effectively.
• Proficiency in Microsoft Office (Word, Excel) and electronic health record systems (e.g., Epic).
• Must successfully complete systems training requirements.

Preferred Qualifications

• Experience in a physician practice or healthcare setting.
• Experience in EPIC.
• Familiarity with quantitative and qualitative data analysis related to coding and billing.

Competencies

Patient Facing Competencies	Minimum Proficiency Level
Accountability & Self-Management	Level 3 - Intermediate
Adaptability to Change & Learning Agility	Level 2 - Basic
Communication	Level 2 - Basic
Customer Service & Patient Centered	Level 3 - Intermediate
Emotional Intelligence	Level 3 - Intermediate
Problem Solving & Decision Making	Level 3 - Intermediate
Productivity & Time Management	Level 3 - Intermediate
Teamwork & Collaboration	Level 2 - Basic
Quality, Patient & Workplace Safety	Level 3 - Intermediate
Leadership Competencies	Minimum Proficiency Level
Business Acumen & Vision Driver	Level 1 - Introductory
Performance Management
Innovation & Organizational Development	Level 1 - Introductory

Equal Opportunity Employer / Disability / Veteran

Columbia University is committed to the hiring of qualified local residents.