Billing Compliance Specialist

Weill Cornell Medicine - Qatar; New York (NY); On-site; USD 75,000 - 110,000; Full time

Job summary

Weill Cornell Medicine - Qatar is seeking a billing compliance professional to monitor physician billing activity for accuracy and policy adherence.

You will track audits, analyze coding patterns, educate staff on compliant coding, and help implement improved controls and reporting.

Ideal candidates hold a Bachelor's degree, 2–3 years in medical records or physician billing, 1–2 years as a coder, and CPC certification.

Qualifications

• Knowledge of professional billing, including physician billing and reimbursement.
• Understanding of third party reimbursement.

Responsibilities

• Monitor physician billing activity for compliance and audit feedback.
• Track audits and prepare reports on results.
• Describe coding patterns and educate staff on compliant coding.

Skills

Billing compliance knowledge

Professional coding knowledge

Education

Bachelor's Degree in related field

Job description

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Position Summary

Monitors physician billing activity for compliance and audit feedback processes.

Job Responsibilities

• Tracks and trends results of audits. Prepares and presents reports on results.
• Analyzes physician coding patterns and other documentation utilizing electronic databases.
• Assists in orienting new employees/faculty to departmental billing and compliance policies and procedures and notifies new employees/faculty of upcoming compliance training workshop dates.
• Monitors coding and medical record documentation compliance with federal and state regulations. Educates clinical staff and providers on compliant coding for maximum revenue.
• Designs audit tools and methodology for conducting audits. Conducts prospective and retrospective compliance documentation audits. Maintains integrity of electronic and hard copy files and databases.
• Researches and educates providers on appropriate coding for provider specialty.
• Trains as necessary on coding/documentation changes implemented internally and by insurance carriers.
• Monitors effectiveness of corrective action plans.
• Evaluates current compliance plan, makes recommendations for changes, and implements and executes new policies and procedures.
• Attends workshops, seminars and/or conferences to keep abreast of standards and best practices within the field. Disseminates information to colleagues and/or staff as appropriate.
• Identifies trends in revenue cycle activities, including payments, denials, billing, coding and/or documentation errors. Recommends actions plans to address deficiencies. Monitors implementation of corrective action plans.

Education

• Bachelor's Degree in related field

Experience

Approximately 2-3 years of experience in medical records and/or physician billingApproximately 1-2 years of experience as medical coder

Knowledge, Skills and Abilities

• Demonstrated knowledge of professional billing, including physician billing, reimbursement, and carrier relations.
• Demonstrated knowledge of third party reimbursement.

Licenses and Certifications

• Certified Professional Coder Certificate (CPC)

Working Conditions/Physical Demands

Standard office work

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