Medical Coding Specialist Lead

Weill Cornell Medical College•New York, NY

9d•$78,100 - $84,500•Onsite

About The Position

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

Requirements

High School Diploma
Approximately 3 years of experience in physician billing and coding
Prior experience working with an eMR system.
Working knowledge of federal and state reimbursement regulations.
Knowledge of third party insurance billing policies and procedures.
Certified coder (CPC, CCS-P)

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.