Coding Specialist III

• Job Type: Officer of Administration
• Bargaining Unit:
• Regular/Temporary: Regular
• End Date if Temporary:
• Hours Per Week: 35
• Standard Work Schedule: Mon - Fri (9am - 5pm)
• Building: Columbia University Medical Center
• Salary Range: $72,000 - $85,000

Position Summary

The Coding Specialist III is responsible for the review and resolution of all coding related prebilling edits and/or rejections to ensure prompt and accurate reimbursement. This position initiates medical record review and recommends proper action. This position works closely with the Directors of Revenue and Practice Operations to adjudicate and resolve claims.

Responsibilities

• Review and resolve all assigned tasks/encounters associated with coding discrepancies as it relates to pre-billing system edits and/or claims with outstanding balances.
• Reduces accounts receivable by reviewing claims rejected for coding. Investigates assigned accounts to determine what additional steps must be taken for claims to be resolved.
• Provide guidance and suggestions to clinical departments for pre-billing coding edits.
• Maintains patient confidentiality; complies with HIPAA and compliance guidelines established by the hospital.
• Review and follow up on denials related to coding and charge entry processes; if a claim is denied due to incorrect coding, conducts medical records research and corresponds with insurance companies and clinicians to resolve issue.
• Manages appeals with insurance companies for surgical claim reimbursement when appropriate.
• Assess clinical documentation supporting services.
• Oversee to insurance coding requests.
• Assists with claim issues, including preparing coding appeals.
• Serves as liaison between clinicians, billing consultants, patient financial counselor and insurance carriers to discuss coding issues.
• Review and analyze coding trends to improve unnecessary coding rejections. 
• Create new edits related to payors and CMS guidelines to release to clearing house.
• Trains new coders and billers.
• Support other functions as assigned. 

Minimum Qualifications

• Bachelor's degree or equivalent in education and experience. 
• Three years of related experience. 

Preferred Qualifications

• Certified Professional Coder (CPC).
• Intermediate MS Office skills.

Other Requirements

• Transplant Coding Knowledge.
• Knowledge of CPT and ICD-IO coding.
• Strong written and verbal communication skills.
• Working knowledge of contracts, insurance billing requirements, payers, Medicare and Medicaid.
• Ability to follow- through and handle multiple tasks simultaneously.
• Proven to exceed standard productivity levels.
• Proven attendance and punctuality record.

Equal Opportunity Employer / Disability / Veteran

Columbia University is committed to the hiring of qualified local residents.