Coding Integrity Specialist Boynton Beach Florida

NYU Langone Health; Boynton Beach (FL); On-site; USD 65,000 - 85,000; Full time

Job summary

NYU Langone Health is seeking a Coding Integrity Specialist in Boynton Beach, Florida. The ideal candidate will have a bachelor's degree and 4-6 years of experience in auditing and revenue cycle management in a healthcare environment. Responsibilities include auditing documentation and billing accuracy, developing reports, and providing guidance to coding teams. Candidates must possess extensive knowledge of coding guidelines and relevant certifications. An inclusive workplace is emphasized as part of NYU Langone's commitment.

Qualifications

• 4-6 years of auditing and revenue cycle management experience in a healthcare environment.
• Extensive knowledge of coding principles and guidelines.
• Knowledge of the RAC process and federal regulations pertaining to documentation, coding, and billing.
• Ability to communicate complex information effectively.

Responsibilities

• Review and audit clinical documentation and coding for accuracy.
• Develop reports reflecting audit findings and present them to leadership.
• Provide coding and compliance guidance to offshore coding teams.
• Research and update coding and compliance standards.

Skills

Auditing experience

Coding principles and guidelines

Interpersonal communication

Organizational skills

Attention to detail

Research skills

Education

Bachelor’s degree

Certified Coding Specialist Certification (CCS)

Certified Professional Coder (CPC)

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Electronic Medical Records (EMR)

Job description

Position Summary

We have an exciting opportunity to join our team as a Coding Integrity Specialist.

In this role, the successful candidate reports to the Coding Quality Manager.

Job Responsibilities

• Perform other duties as needed.
• Objectively review and audit clinical documentation, CPT‑4, HCPCS, modifiers and ICD‑10 coding to ensure accurate reimbursement and compliance with CMS and third‑party payer laws and regulations.
• Develop complete reports reflecting audit findings, including negative and positive trends. Report findings to leadership and follow through as directed.
• Effectively and professionally communicate complex information in both oral and written formats in a way that is understandable to the audience.
• Provide professional coding, billing, and compliance guidance/education to offshore coding teams.
• Independently analyze and weigh the risks versus benefits in decisions and recommendations related to provider billing and audit issues.
• Promptly report any potential compliance issues to leadership and the Director of Compliance if necessary.
• Research and update new and/or revised coding and compliance standards utilizing multiple government resources including CMS, AMA, OIG, etc.
• Assist in the development of coding policies and procedures.
• Review, monitor, and facilitate implementation of billing and coding changes affecting charge capture processes in accordance with payer requirements.
• Apply critical thinking, negotiation and conflict resolution skills.
• Maintain collaborative relationships with internal and external teams to ensure integration and alignment of department priorities.
• Effectively use various computer applications to conduct research, create reports and presentation material.
• Assist with special projects on an as‑needed basis.
• Prepare and present coding materials at revenue cycle meetings.

Minimum Qualifications

• Fresh to clear to have a bachelor’s degree and 4‑6 years of auditing and revenue cycle management experience in a healthcare environment.
• Extensive knowledge of coding principles and guidelines.
• Knowledge of the RAC process including targeted coding areas.
• Extensive knowledge of reimbursement systems, as well as federal, state and payer‑specific regulations and policies pertaining to documentation, coding and billing.
• Knowledge of Electronic Medical Records.
• Proficient in Microsoft Office applications: Word, Excel and PowerPoint and others as required.
• Strong interpersonal communication and presentation skills, effectively presenting information to management, faculty practice groups and individuals.
• Excellent organizational and project management skills.
• Strong time management, attention to detail and follow‑through.
• Well‑developed research skills.
• Strong knowledge of revenue cycle process, revenue integrity and its impact throughout the revenue cycle.
• Required license/certification: Certified Coding Specialist Certification (CCS) or Certified Coding Specialist‑Physician‑based (CCS‑P) or Certified Professional Coder (CPC), Certified Outpatient Coding (COC).
• Light, accurate keyboarding skills; candidates must score 35 words per minute or greater on the typing assessment administered prior to onboarding.

Required Licenses

Outpatient Coder - Cert, Coding Specialist - Physician-Cert, Certified Coding Specialist.

Qualified candidates must be able to effectively communicate with all levels of the organization.

NYU Langone Florida is an equal opportunity employer and committed to inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration. We require applications to be completed online.