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About the Role
Under supervision, this role assists in the development and evolution of the overall strategy for the department’s coding operations. It is also responsible for reviewing medical records for compliance with coding and documentation requirements.
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.
Requirements
- Prior experience working with an eMR system.
- Working knowledge of federal and state reimbursement regulations.
- Knowledge of third party insurance billing policies and procedures.
Skills
- Medical coding
- Billing
- Compliance
- Charge entry
- Payment posting
- Claim resolution
- Claim resubmission
- Claim appeals
- Auditing
- Reporting
- Spreadsheet development
- Database development
Location
- Midtown
Work Type
- Onsite
Experience Level
- 3 years of experience in physician billing and coding
Education Level
- High School Diploma
- Certified coder (CPC, CCS-P)
Salary/Compensations
- $78,100.00 - $84,500.00
About the Company
- Cornell welcomes students, faculty, and staff with diverse backgrounds from across the globe to pursue world-class education and career opportunities, to further the founding principle of “any person, any study.”
Equal Opportunity
- No person shall be denied employment on the basis of any legally protected status or subjected to prohibited discrimination involving, but not limited to, such factors as race, ethnic or national origin, citizenship and immigration status, color, sex, pregnancy or pregnancy-related conditions, age, creed, religion, actual or perceived disability (including persons associated with such a person), arrest and/or conviction record, military or veteran status, sexual orientation, gender expression and/or identity, an individual’s genetic information, domestic violence victim status, familial status, marital status, or any other characteristic protected by applicable federal, state, or local law.
- Cornell University embraces diversity in its workforce and seeks job candidates who will contribute to a climate that supports students, faculty, and staff of all identities and backgrounds.
- We hire based on merit, and encourage people from historically underrepresented and/or marginalized identities to apply.
- Consistent with federal law, Cornell engages in affirmative action in employment for qualified protected veterans as defined in the Vietnam Era Veterans’ Readjustment Assistance Act (VEVRRA) and qualified individuals with disabilities under Section 503 of the Rehabilitation Act.
- We also recognize a lawful preference in employment practices for Native Americans living on or near Indian reservations in accordance with applicable law.