Coding Specialist II — Prebilling & Denials Expert

Columbia University Irving Medical Center; New York (NY); On-site; USD 68,000 - 75,000; Full time

Job summary

Columbia University Irving Medical Center is seeking a Coding Specialist to review and resolve prebilling coding edits and denials. You will work with the Department of Surgery to ensure accurate documentation and prompt reimbursement.

The role requires a CPC, a bachelor's degree or equivalent, and at least 3 years of related experience. This on-site position supports HIPAA compliance and cross-functional collaboration with clinicians and billing staff.

Qualifications

• Bachelor's degree or equivalent in education and experience.
• 3 years of related experience.
• Certified Professional Coder (CPC).

Responsibilities

• Review and resolve coding discrepancies related to prebilling system edits and claims with outstanding balances.
• Reduce accounts receivable by reviewing claims denied for coding and investigate actions to resolve them.
• Provide guidance to clinical departments for prebilling coding edits.
• Maintain patient confidentiality; comply with HIPAA and hospital standards.
• Follow up on denials due to incorrect coding; conduct medical records research and contact insurers/clinicians to resolve issues.
• Manage appeals with insurers for surgical claim reimbursement as appropriate.
• Assess clinical documentation supporting services.
• Respond to insurance coding requests.
• Assist with claims issues, including coding appeals.
• Serve as liaison between clinicians, billing staff, patients, and insurers to discuss coding issues.
• Maintain tracking reports for issues and trends.

Skills

CPT coding

ICD-IO coding

MS Office

Communication skills

Billing knowledge

Education

Bachelor's degree or equivalent

Job description

Columbia University Irving Medical Center is seeking a Coding Specialist to review and resolve prebilling coding edits and denials. You will work with the Department of Surgery to ensure accurate documentation and prompt reimbursement.

The role requires a CPC, a bachelor's degree or equivalent, and at least 3 years of related experience. This on-site position supports HIPAA compliance and cross-functional collaboration with clinicians and billing staff.