Position Summary:

We have an exciting opportunity to join our team as a Coding Coordinator II. This position will be based onsite at our Las Vegas, NV office.

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, as part of the revenue cycle team.

Job Responsibilities:

• Perform other duties as needed.
• Monitor reports and assigned work queues, ensuring coding, charge submission, and accounts receivable follow-up are 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, draft 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 a 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 charges that require 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 work queue 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 the billing system. Review billing collection and denial reports and recommend changes on how to improve issues.
• Serve as a liaison to the 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 daily.
• 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 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 bachelor’s degree with a minimum of 3-5 years of relevant work experience or an equivalent combination of 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 a high level of accuracy in reviewing charge batch submissions, analyzing and correcting coding denials, and preparing and presenting analyses.
• Stays up to date with industry requirements.
• Knowledge of medical terminology is required.
• Familiar with standard office equipment.
• Light, accurate keyboarding skills are required. Candidates must receive a score of 35 words per minute (wpm) or greater on the typing assessment that will be administered before onboarding.

Preferred Qualifications:
Certified Coding Specialist Certification (CCS) Certified Coding Specialist- Physician-based (CCS-P) Certified Professional Coder (CPC), or Certified Outpatient Coding (COC) preferred.

NYU Langone Nevada is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.

If you wish to view NYU Langone Nevada’s EEO policies, please click here. Please click here to view the Federal “EEO is the law” poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information.

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