Position Summary:
We have an exciting opportunity to join our team as a Coding Coordinator II.
Become a key member of the NYU Langone Health Faculty Group Practice Central Billing Offices (FGP CBO). Coordinate all aspects of coding review, claim submission, charge reconciliation and follow-up on claims denied for coding-related reasons for various specialties and providers. Provide coding, financial and/or operational reports, and provide feedback to providers to improve documentation to maximize revenue and reduce denials. Review and train practices on local and national coding and reimbursement policies including payer coding guidelines. Work with patients and guarantors to clarify financial responsibilities as needed.
Job Responsibilities:
- Perform other duties as needed.
- Monitor reports and assigned workqueues, ensuring coding, charge submission and accounts receivable follow-up is occurring on a timely basis.
- Perform charge reconciliation to validate all revenue is captured.
- Review claims denied for coding errors, bundling, medical necessity, and/or other related reasons. Correct coding errors, drafts appeal letters based on physician documentation and coding guidelines, submit supplemental claim information to insurance companies and follow-up on appeals as necessary.
- Identify coding or documentation issues and suggest improvements to physicians. Escalate issues as needed to practice and FGP Leadership.
- Communicate with, and train, coding and A/R vendors as it relates to various coding, reimbursements, billing processes and collections.
- Work with front-end staff to ensure patient insurance information and benefits are verified accurately and timely. Act as a resource to front end practice staff to identify gaps in financial clearance processes.
- Review and respond to practice, physician, and patient inquiries following CBO guidelines, payer rules, compliance regulations and related rules.
- Serve as resource to physicians, staff, and management regarding local and national coding and reimbursement policies.
- Collaborate with the corporate Revenue Integrity Analysts to understand CPT and ICD-10 guidelines, payer policy and procedure manuals, updates, and CMS publications to ensure practices are compliant with current policies and procedures. Train physicians, other staff, and management, as needed.
- Adhere to general practice and FGP guidelines on compliance issues and patient confidentiality.
- Review unbilled charge reports and follow up with physicians and/or practice management for unbilled services.
- Meet CBO quality and productivity targets.
- Review practice Action Plans and/or reports on a timely basis. Analyze issues to identify trends in denial rates to focus improvement initiatives on, and charges that requires action.
- May act as a financial counselor to patients who require assistance understanding their benefits and financial options. Act as the patient advocate with the patient and/or family members and liaison with the insurance companies to assist in obtaining insurance information.
- Take initiative to teach and share new information and provide constructive feedback. Communicate delays and workqueue issues to management daily.
- Lead and collaborate with practice personnel and administration to implement change to practice operations where necessary, to improve accuracy of information and enhance revenue.
- Ensure timely and accurate collection, preparation, and verification of billing information submitted in billing system. Review billing collection and denial reports and recommend changes on how to improve issues.
- Serve as a liaison to coding vendor for questions, data requests, and other inquiries. Review charge encounter forms for complete CPT code, ICD-10 code, and other required billing information on a daily basis.
- Compare coding to notes/documentation and communicate with providers to clarify errors, correct coding and prepare appeals and reconsideration requests. Appeal complex denials through review of payer policies, coding, contracts, and medical records. Utilize subject matter experts as needed.
- Analyze/audit notes and ensure the appropriate codes are charged in order to maintain billing compliance and prevent denials.
- Identify denial trends and train practice staff to avoid denials in the future, emphasizing accurate charge capture, appropriate authorization review, etc. Develop supporting training documentation as needed with FGP management.
- Staff who possess coding certification at the time of hire or who obtain coding certification while employed by NYU must maintain active status of certification.
Minimum Qualifications:
To qualify you must have a Bachelors degree with a minimum of 3-5 years of relevant work experience or equivalent combination or training and relevant work experience.
Ability to multitask and prioritize.
Good communication, interpersonal, and computer skills.
Ability to develop and maintain effective working relationships with staff and patients.
Detail-oriented with high level of accuracy for reviewing charge batch submissions, analyzing and correcting coding denials, preparing, and presenting analyses.
Stays up to date with industry requirements.
Knowledge of medical terminology required.
Familiar with standard office equipment.
Light, accurate keyboarding skills required. Candidates must receive a score of 35 words per minute (wpm) or greater on the typing assessment that will be administered prior to onboarding..
Required Licenses: Outpatient Coder - Cert, Coding Spclst - Physician-Cert, Certified Professional Coder, Certified Coding Specialist
Preferred Qualifications:
Certified Coding Specialist Certification (CCS) or Certified Coding Specialist- Physician-based (CCS-P) or Certified Professional Coder (CPC), or Certified Outpatient Coding (COC) preferred.
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU Langone Florida provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents. At NYU Langone Health, we are committed to supporting our workforce and their loved ones with a comprehensive benefits and wellness package. Our offerings provide a robust support system for any stage of life, whether it's developing your career, starting a family, or saving for retirement. The support employees receive goes beyond a standard benefit offering, where employees have access to financial security benefits, a generous time-off program and employee resources groups for peer support. Additionally, all employees have access to our holistic employee wellness program, which focuses on seven key areas of well-being: physical, mental, nutritional, sleep, social, financial, and preventive care. The benefits and wellness package is designed to allow you to focus on what truly matters. Join us and experience the extensive resources and services designed to enhance your overall quality of life for you and your family.
NYU Langone Florida is an equal opportunity employer and committed to inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration. We require applications to be completed online.
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