Medical Coding Specialist Lead

Weill Cornell Medicine; New York (NY); On-site; USD 78,000 - 85,000; Full time

Job summary

Weill Cornell Medicine in Midtown seeks a Medical Coding Specialist Lead to help develop and evolve the department's coding operations. Under supervision, you will review medical records for coding and documentation compliance and support the implementation of coding standards.

The ideal candidate has about 3 years of physician billing and coding experience, with CPC or CCS-P certification, and familiarity with an eMR system to ensure accurate reimbursements.

Qualifications

• High School Diploma required.
• Approximately 3 years of physician billing/coding experience.
• CPC or CCS-P certification preferred.
• Knowledge of federal/state reimbursement regulations and third-party billing policies.

Responsibilities

• Composes and maintains billing correspondence and resolves billing issues.
• Performs charge entry and posting; tracks denied claims and resubmits when needed.
• Keeps up with coding standards through workshops and conferences.
• Analyzes coding activities and recommends system changes.
• Reviews audit results with clinical faculty to ensure compliance.
• Performs prospective coding reviews for documentation adequacy.

Skills

eMR system

Regulatory knowledge

Medical billing knowledge

Documentation accuracy

Education

High School Diploma

Tools

eMR software

Job description

As required under NYC Human Rights Law Int 1208-2018 - Salary range for this role when Hired for NYC Offices

Title: Medical Coding Specialist Lead

Location: Midtown

Org Unit: Administration

Work Days

Weekly Hours: 35.00

Exemption Status: Exempt

Salary Range: $78,100.00 - $84,500.00

Position Summary

Under supervision, assists in the development and evolution of the overall strategy for the departments coding operations This role is also responsible for reviewing medical records for compliance with coding and documentation requirements

Job Responsibilities

• Composes and maintains billing and/or billing compliance associated correspondence. Determines proper account resolution and/or adjustment as needed.
• Performs charge entry and/or payment posting within the practice management billing system as needed. Tracks and resolves issues on denied claims. Resubmits or appeals claims as required. Escalates more complex claim issues when necessary.
• 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.
• Analyzes coding activities and recommends systemic changes. Facilitates approved changes.
• Meets regularly with clinical faculty and leadership to review compliance audit results, to ensure compliance with internal and external policies and regulations.
• Conducts prospective coding reviews of outpatient, inpatient and procedure documentation to ensure that the documentation supports the services billed and all documentation standards are met.
• Reviews findings of chart reviews with individual providers and recommends appropriate coding corrections.
• Addresses and resolves coding errors.
• Educates providers about coding changes and new compliance policies and regulations.
• Updates demographics and insurance information within the practice management system.
• Verifies eligibility prior to claim submission.
• Tracks compliance errors.
• Actively monitors employee performance and escalates issues or concerns.
• Develops routine and ad hoc reports, spreadsheets and databases analyzing and summarizing billing information.
• Ensures compliance with regulatory audits/inspections and/or internal reviews. Develops and recommends corrective action plans to address deficiencies identified. May serve as liaison to audit team(s) during on-site visits.

Education

• High School Diploma

Experience

Approximately 3 years of experience in physician billing and coding

Knowledge, Skills and Abilities

• Prior experience working with an eMR system.
• Working knowledge of federal and state reimbursement regulations.
• Knowledge of third party insurance billing policies and procedures.

Licenses and Certifications

• Certified coder (CPC, CCS-P)

Working Conditions/Physical Demands

Standard office work

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