• Job Type: Officer of Administration
• Bargaining Unit:
• Regular/Temporary: Regular
• End Date if Temporary:
• Hours Per Week: 35
• Standard Work Schedule:
• Building:
• Salary Range: $63,700 - $65,000

Position Summary

The CPC Coding & Billing Specialist will be 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 reviews and recommends proper action. This job role will also review and analyze all charge correction requests and then process any needed adjustments/edits. The individual is the point person within the department responsible for making all charge corrections. Follows organizational policies and procedures to ensure consistency of charge capture processes and reimbursements.

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 with outstanding balances.
• Assess clinical documentation supporting services.
• Research and respond to insurance coding requests.
• Research accounts and request any needed supporting documentation.
• Meet providers periodically to review their surgical cases and give providers any coding suggestions and advice related to insurance coding policy to improve the coding accuracy and to reduce the coding denial.   
• Analyze charge correction requests that are submitted.
• Execute charge corrections in order to ensure to achieve account resolution.
• Generate reports to monitor the types of errors and their frequency.
• Resolve all correction requests accurately and in a timely approach.
• Review and analyze denials and reach out to payers in an attempt to settle accounts.
• Responsible for performing edits on high dollar accounts.
• The scope of responsibility may include utilizing reports to monitor volumes and overall success rates.
• Assist coding and charging edits specialist with questions and concerns coding and edits.
• Assist with claim issues, including preparing coding appeals.
• Assist in developing policies and procedures related to Charge Corrections.
• Proactively elevates coding problems to leadership.
• Keep the supervisor informed of the progress of all tasks.
• Act as a point of escalation and monitor supervisory or secondary work queues
• Perform related duties as assigned within the scope of practice.

Minimum Qualifications

• Requires a bachelor’s degree or equivalent in education and experience, plus three years of related experience.
• CPC Certification required
• DME experience required
• Candidate must demonstrate working knowledge of contracts, insurance benefits, exclusions, and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid and compliance

Equal Opportunity Employer / Disability / Veteran

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