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Revenue Cycle Specialist-revenue Integrity
4 months ago
**Title**:Revenue Cycle Specialist-Revenue Integrity (REMOTE)**:
Title: Revenue Cycle Specialist-Revenue Integrity (REMOTE)
Location: Midtown
Org Unit: Reg/Elig/COB
Work Days:
Exemption Status: Non-Exempt
Salary Range: $29.15 - $35.00
- As required under NYC Human Rights Law Int 1208-2018 - Salary range for this role when Hired for NYC Offices
**Position Summary**:
**Responsibilities**:
- 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.
- 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.
**Education**:
- High school diploma or GED in related field
**Experience**:
- 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.
**Knowledge, Skills and Abilities**:
- Proficient in CPT and ICD10 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.
**Licenses and Certifications**:
- Certified Professional Coder Certificate (CPC) or Certified Coding Specialist (CCS)
**Working Conditions/Physical Demands**:
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 Cornell Physician Organization - are engaged in world-class clinical care and cutting-edge research that connect patients to the latest treatment innovations and prevention strategies. Located in the heart of the Upper East Side's scientific corridor, Weill Cornell Medicine's powerful network of collaborators extends to its parent university Cornell University; to Qatar, where an international campus offers a U.S. medical degree; and to programs in Tanzania, Haiti, Brazil, Austria and Turkey. Our medical practices serve communities throughout New York City, and our faculty provide comprehensive care at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian/Lower Manhattan Hospital, NewYork-Presbyterian Hospital/Brooklyn Methodist Hospital, NewYork-Presbyterian Hospital/Westchester Behavioral Health Center, and NewYork-Presbyterian/Queens. At Weill Cornell Medicine, we work together to treat each individual, not just their conditions or illnesses, as we strive to deliver the finest possible care for our patients - the center of everything we do. Weill Cornell Medicine is an Equal Employment Opportunity Employer. Weill Cornell Medicine provides equal employment opportunities to all qualified applicants without regard to race, sex, sexual orientation, gender identity, national origin, color, age, religion, protected veteran or disability status, or genetic information.
**Nearest Major Market**:Manhattan
**Nearest Secondary Market**:New York Ci
