Revenue Cycle Specialist-Revenue Integrity | N

Revenue Cycle Specialist-Revenue Integrity

Title:

Revenue Cycle Specialist-Revenue Integrity

Location:

Midtown, New York, NY

Org Unit: AR - Coding Medicine

Work Days:
Weekly

Hours:

35.00

Exemption Status:
Non-Exempt

Salary Range: $29.15 - $35.00

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

Remote position - Join a team of dedicated revenue cycle professionals in the Central Business Office (CBO) of Weill Cornell Medicine (WCM). Apply your knowledge as a Certified Professional Coder to investigate and resolve coding related insurance payment denials. The CBO partners with WCM Clinical Departments to increase and expedite service revenue, reduce aged AR, and trend denials for their root causes thereby driving efficiencies, to include clinical documentation improvement and coding denials prevention.

• Performs retrospective coding and documentation review of denied charges for physician services. Reviews medical records for completeness and accuracy to ensure documentation supports the services billed and all documentation standards are met for billing.
• Analyze for invalid denial trends, payer specific carrier submission requirements & system optimization.
• Performs extensive follow-up to investigate and resolve payment denial trends.
• Resolves outstanding accounts utilizing ancillary applications and websites as tools to retrieve medical documentation, claim status and billing guidelines to substantiate corrected claim submissions, written appeals, coding and medical necessity reviews.
• Researches and interprets payer contract terms and compiles necessary supporting documentation templates for appeals according to various payer claim guidelines.
• Ensures denial reviews are conducted in a timely manner.
• Maintains up-to-date policies and procedures and knowledge related to managed care and third party payors.
• Participates in annual and on-going mandatory compliance training. Fulfills Continuing Education Units necessary to maintain certification status.
• Assists in training current and new employees on the use of systems and departmental policies and procedures.
• Performs other related duties as assigned.

• High school diploma or GED in related field

• Certification as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS).
• Should be certified from AHIMA or from AAPC.
• Approximately 3-5 years of physician billing experience, specifically accounts receivable and collection experience.
• Prior experience working with an eMR systems.
• Knowledge of medical terminology.
• Knowledge of third-party reimbursement.
• Microsoft Excel and other reporting software to sort, filter, summarize and identify various account receivable trends.

• Proficient in CPT and ICD
  10 CM coding guidelines.
• Ability to meet productivity standards and identify any issues or trends and bring them to the attention of management.
• Demonstrated ability to function independently and exercise independent judgment.
• Demonstrated critical thinking and analytical skills.
• Ability to meet daily coding and denial management production requirements along with quality as per Company norms.
• Strong computer skills in data entry, coding, knowledge of Electronic Medical Record software (Epic), Microsoft Office, Excel.
• Ability to follow coding guidelines and legal requirements to ensure compliance with our Institutional, federal, and state regulations.
• Excellent interpersonal, verbal and communication skills.

• Certified Professional Coder Certificate (CPC) or Certified Coding Specialist (CCS)

Remote based work with rare onsite requirement. Dedicated workspace conducive to a healthy work environment.

Weill Cornell Medicine is a comprehensive academic medical center that is committed to excellence in patient care, scientific discovery, and the education of future physicians and scientists in New York City and around the world. Our doctors and scientists - faculty from Weill Cornell Medical College, Weill Cornell Graduate School of Medical Sciences, and the Weill…