Revenue Cycle Specialist-Revenue Integrity
3 weeks ago
We are seeking a highly skilled Revenue Cycle Specialist-Revenue Integrity to join our team at Weill Cornell Medicine. The successful candidate will be responsible for investigating and resolving coding-related insurance payment denials, working closely with our Clinical Departments to increase and expedite service revenue, reduce aged AR, and trend denials for their root causes.
Key Responsibilities:- Denial Management: Perform retrospective coding and documentation review of denied charges for physician services, ensuring documentation supports the services billed and all documentation standards are met for billing.
- Analysis and Resolution: Analyze denial trends, payer-specific carrier submission requirements, and system optimization to resolve payment denials.
- Account Resolution: Resolve outstanding accounts using 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.
- Payer Contract Research: Research and interpret payer contract terms and compile necessary supporting documentation templates for appeals according to various payer claim guidelines.
- Timely Denial Reviews: Ensure denial reviews are conducted in a timely manner.
- Compliance and Training: Maintain up-to-date policies and procedures and knowledge related to managed care and third-party payors, participate in annual and ongoing mandatory compliance training, and fulfill Continuing Education Units necessary to maintain certification status.
- Training and Support: Assist in training current and new employees on the use of systems and departmental policies and procedures.
- Certification: Certification as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) is required.
- Experience: Approximately 3-5 years of physician billing experience, specifically accounts receivable and collection experience.
- Skills: Proficient in CPT and ICD10 CM coding guidelines, ability to meet productivity standards, identify issues or trends, and bring them to the attention of management.
Weill Cornell Medicine is a comprehensive academic medical center committed to excellence in patient care, scientific discovery, and the education of future physicians and scientists. Our doctors and scientists are engaged in world-class clinical care and cutting-edge research that connect patients to the latest treatment innovations and prevention strategies.
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Revenue Cycle Specialist
3 weeks ago
New York, New York, United States Weill Cornell Medical College Full timeJob Title: Revenue Cycle Specialist - Revenue IntegrityLocation: RemoteJob Summary: We are seeking a skilled Revenue Cycle Specialist to join our team at Weill Cornell Medicine. The successful candidate will be responsible for investigating and resolving coding-related insurance payment denials, working closely with our clinical departments to increase and...
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Revenue Cycle Specialist
3 weeks ago
New York, New York, United States Weill Cornell Medical College Full timeKey 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...
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Revenue Cycle Specialist
3 weeks ago
New York, New York, United States Weill Cornell Medical College Full timeJob SummaryWe are seeking a skilled Revenue Cycle Specialist - Revenue Integrity to join our team at Weill Cornell Medicine. As a key member of our Central Business Office, you will play a critical role in investigating and resolving coding-related insurance payment denials. Key Responsibilities• Perform retrospective coding and documentation review of...
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