Revenue Cycle Specialist
3 weeks ago
Key Responsibilities:
As a Revenue Cycle Specialist - Revenue Integrity at Weill Cornell Medicine, you will be responsible for investigating and resolving coding-related insurance payment denials. You will work with our Clinical Departments to increase and expedite service revenue, reduce aged accounts receivable, and trend denials for their root causes.
Responsibilities Include:
- 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.
- Analyzes for invalid denial trends, payer-specific carrier submission requirements, and 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.
Requirements:
- Certification as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) is required.
- Approximately 3-5 years of physician billing experience, specifically accounts receivable and collection experience.
- Prior experience working with an eMR system.
- Knowledge of medical terminology, third-party reimbursement, and Microsoft Excel.
Working Conditions:
This is a remote-based position with rare on-site requirements. Dedicated workspace is provided to ensure a healthy work environment.
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