Coding Integrity Specialist - Boynton Beach, Florida Boynton Beach, FL

SilkRoad; Boynton Beach (FL); On-site; USD 70,000 - 110,000; Full time

Job summary

NYU Langone Florida in Boynton Beach seeks a Coding Integrity Specialist to audit clinical documentation and coding (CPT-4, HCPCS, ICD-10) for accurate reimbursement and CMS compliance. The role reports to the Coding Quality Manager and collaborates with cross-functional teams.

Qualified candidates have a Bachelor's degree and 4–6 years in auditing and revenue cycle management, plus CCS/CCS-P/CPC/COC certifications and strong communication skills.

Qualifications

• Bachelor's degree and 4–6 years of auditing and revenue cycle experience in healthcare.
• Extensive knowledge of coding principles and guidelines.
• Knowledge of RAC processes and payer regulations.

Responsibilities

• Audit clinical documentation, CPT-4, HCPCS, modifiers and ICD-10 coding for accuracy and CMS compliance.
• Develop reports reflecting audit findings and trends for leadership.
• Communicate complex information clearly in oral and written form.
• Provide coding guidance to offshore coding teams and educate on compliance.
• Research coding standards using CMS, AMA, OIG resources and update policies as needed.
• Support billing and charge capture processes and assist with special projects.

Skills

Auditing

Revenue cycle

CMS compliance

Communication

Office software

Education

Bachelor's degree

Tools

Microsoft Office

Electronic Medical Records

Job description

Coding Integrity Specialist - Boynton Beach, Florida

Boynton Beach

ID: 1156783_RR00116460

Full-Time/Regular

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.
• Develops complete reports reflecting audit findings including negative and positive trends. Reports findings to leadership and follows through as directed.
• Effectively and professionally communicate complex information in both oral and written format 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 verses benefits in decisions and recommendations related to provider billing and bill audit issues.
• Promptly report any and all 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.
• Reviews, monitors, and facilitates 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 as-needed basis.
• Prepares and presents coding materials at revenue cycle meetings.

Minimum Qualifications:

To qualify you must 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 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 Licensure/Certification skills: 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 required. Candidates must receive a score of 35 words per minute (wpm) or greater on the typing assessment that will be administered prior to onboarding..

Required Licenses: Outpatient Coder - Cert, Coding Spclst - Physician-Cert, Certified Coding Specialist

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

NYU Langone Florida provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents. At NYU Langone Health, we are committed to supporting our workforce and their loved ones with a comprehensive benefits and wellness package. Our offerings provide a robust support system for any stage of life, whether it's developing your career, starting a family, or saving for retirement. The support employees receive goes beyond a standard benefit offering, where employees have access to financial security benefits, a generous time-off program and employee resources groups for peer support. Additionally, all employees have access to our holistic employee wellness program, which focuses on seven key areas of well-being: physical, mental, nutritional, sleep, social, financial, and preventive care. The benefits and wellness package is designed to allow you to focus on what truly matters. Join us and experience the extensive resources and services designed to enhance your overall quality of life for you and your family.

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.

View Know Your Rights: Workplace discrimination is illegal .