Position Summary

The Coding Specialist 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 communicates with department clinical and billing staff regarding missing or unclear documentation. In addition to maintaining standard productivity levels, the coding specialist works closely with the Director of Coding and Billing Optimization on assigned tasks.

Responsibilities

RESPONSIBILITIES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING:

• Assist surgeons and clinical teams in assigning appropriate codes based on diagnosis and planned surgical procedures
• Review medical documentation to ensure all diagnosis codes and CPT codes are appropriately captured.
• Review surgeon's operative reports daily to ensure all diagnosis codes and CPT codes are billed correctly; informs authorization and billing department if codes need to be reconciled between procedures planned versus performed
• 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
• Assist in the review process of medical documentation for support in the appeal and redetermination of denied claims for medical necessity
• Conforms to all applicable HIPAA, billing compliance and safety guidelines

Minimum Qualifications

Requires a bachelor's degree or equivalent in education and experience, plus three years of related experience.
Certified Professional Coder (CPC) certification is required.
Knowledge of CPT and ICD-I0 coding

Preferred Qualifications

Experience in providing feedback to physicians regarding how to improve clinical documentation in office and operative reports Experience in managing appeals with insurance companies

Surgical sub-specialty preferred knowledge of EPIC

Specialty in Neurosurgery

Other Requirements

 Physician Billing

Equal Opportunity Employer / Disability / Veteran

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