Staff Assistant 2 - Radiology

Upstate; City of Syracuse (NY); On-site; USD 45,000 - 65,000; Full time

Job summary

Upstate Health is seeking a Billing and Coding Analyst to analyze ABN waivers, pre-authorizations, referrals, and insurance demographics to ensure accurate documentation and medical necessity.

You will collaborate with physicians, patients, and hospital staff to obtain correct information at scheduling and coordinate pre-registration, audits, and denial reviews while monitoring coding rules and payer requirements.

Qualifications

• Associates degree with 2 years in an administrative role or equivalent.
• Course work in Medical Terminology, Medical Coding or Medical Assistant program.
• Preferred CPC or CCS certification is a plus.

Responsibilities

• Analyze ABN waivers, pre-authorizations, referrals, and demographics for accuracy.
• Ensure medical necessity and documentation meet coding standards.
• Interact with physicians, patients, and staff to obtain correct information.
• Conduct audits, review insurance denials, and identify improvement actions.

Skills

Medical terminology

ICD-10 coding

CPT coding

Pre-authorization

Documentation auditing

Education

Associates degree

Certified Professional Coder (CPC)

Certified Coding Specialist (CCS)

Job description

Job Summary:

Analyze OP admits for appropriate billing requirements involving Advanced Beneficiary Requirement (ABN) waivers, pre-authorizations, referrals, correct insurance demographic information and medical necessity pertaining to documentation and coding. Will interact with referring physicians, patients, hospital and MSG staff ensuring quality demographic and clinical information is obtained at the time of scheduling or prior to when the exam is ordered. Assist with pre-authorization as needed and coordinate any pre-registration requirements with Patient Access Services. Conduct ongoing internal audits and maintain all documentation. Review and analyze insurance denials, identifying problem areas and recommending and coordinating corrective actions. Review orders for appropriate clinical indications and provide ICD-10 coding. Monitor new billing/compliance regulations for both the Hospital and MSG to determine the impact on operations and charging issues.

Minimum Qualifications:

Associates degree and 2 years relevant experience in an administrative role or equivalent combination of education and experience may be considered. Additional course work or specialized training pertaining to Medical Terminology, Medical Coding, Medical Assistant Program.

Preferred Qualifications:

Certified Professional Coder (CPC) /Certified Coding Specialist (CCS) also preferred. Extensive knowledge of billing requirements according to payer; working knowledge of ICD-10, CPT-2020 coding principles and medical terminology preferred.

Work Days:

Monday-Friday.

Message to Applicants:

RecruitmentOffice: Human Resources