Medical Coding Specialist Lead

Weill Cornell Medical College•New York, NY

6d•$78,100 - $84,500

About The Position

Under supervision, the Medical Coding Specialist Lead assists in developing and evolving the department’s overall strategy for coding operations. The role also reviews medical records for compliance with coding and documentation requirements. It supports billing and claims resolution, analyzes coding activity, conducts coding reviews, educates providers, monitors employee performance, prepares billing reports, and helps ensure compliance with regulatory audits and internal reviews.

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 credential: CPC or CCS-P.

Responsibilities

Compose and maintain billing and billing-compliance correspondence; determine appropriate account resolutions or adjustments.
Perform charge entry and payment posting in the practice management billing system as needed.
Track and resolve denied-claim issues; resubmit or appeal claims and escalate complex issues when necessary.
Attend workshops, seminars, and conferences to stay current on standards and best practices, and share relevant information with colleagues or staff.
Analyze coding activity, recommend systemic changes, and facilitate approved changes.
Meet regularly with clinical faculty and leadership to review compliance audit results and support compliance with internal and external policies and regulations.
Conduct prospective coding reviews of outpatient, inpatient, and procedure documentation to verify that documentation supports billed services and meets documentation standards.
Review chart-review findings with individual providers and recommend coding corrections.
Address and resolve coding errors.
Educate providers about coding changes and new compliance policies and regulations.
Update demographic and insurance information in the practice management system.
Verify eligibility before claim submission.
Track compliance errors.
Monitor employee performance and escalate issues or concerns.
Develop routine and ad hoc reports, spreadsheets, and databases that analyze and summarize billing information.
Ensure compliance with regulatory audits, inspections, and internal reviews; develop and recommend corrective action plans for identified deficiencies; and, when needed, serve as a liaison to audit teams during on-site visits.