Coding Compliance Coordinator (Rehab)

Position Summary

The Coding Compliance Coordinator is responsible for the review and resolution of all coding related prebilling edits and/or rejections to ensure prompt and accurate reimbursement. This position initiates medical record review and recommends proper action. This position communicates with department clinical and billing staff regarding missing or unclear documentation. In addition to maintaining standard productivity levels the coding specialist works closely with the Manager on assigned tasks.

Responsibilities

Operations

• Review pre-billing coding edits in assigned WQ. Review available documentation to ensure selected codes are accurate. Make changes or recommendations to change coding as appropriate to avoid denials by third party carriers.
• Respond to coding denials by coordinating appeals, Letters of Medical Necessity and additional documentation requests. Identify accounts that meet the criteria for adjustment and or write off. Recommend charge corrections
• Identify denial trends and provide management with reports to ensure timely resolution of coding concerns.
• Partner with manager and director to assist with the development of policies and procedures for best practice for coding denial resolution and future system optimization
• Serve as subject matter expert in regard to coding issues and denial trends. Educate employees, faculty and support staff.
• Complete special projects under the direction of the unit manager or director.
• Maintains a thorough working knowledge of all aspects of billing and collections including billing rules and regulations, collection practices, electronic billing processes, CMS 1500 Form requirements, diagnosis and procedure coding, and applicable county, state, and federal requirements. Conforms to all applicable HIPAA, Billing Compliance and safety guidelines and policies.

Strategic

• Work collaboratively with clinical departments to establish effective communications to further the efficiency of the revenue cycle process.
• Develops and maintains a good productive and collaborative relationship with departmental management and representatives.

Compliance and Other

• Performs other job duties as required and assigned.
• Conforms to all applicable HIPAA, Billing Compliance and safety policies and guidelines.

This list of duties and responsibilities is not intended to be all-inclusive and may be expandable to include other duties or responsibilities as necessary.

Please note: While this position is primarily remote, candidates must be in a Columbia University approved telework state. There may be occasional requirements to visit the office for meetings or other business needs. Travel and accommodation costs associated with these visits will be the responsibility of the employee and will not be reimbursed by the company.

Minimum Qualifications

• Requires bachelor’s degree or equivalent in education and experience.
• Minimum of 3 years’ related experience.
• Advanced knowledge CPT and ICD -10 and comprehensive with Managed Care companies, insurance benefits, claim forms Medicare and Medicaid programs.
• Must demonstrate excellent organizational, interpersonal, written and oral communication with all levels of staff, Management, and outside vendors
• Ability to work independently, follow-through and handle multiple tasks simultaneously.
• Must be able to demonstrate willingness to team success develop collaborative relationships with a customer service orientation.
• Must be a motivated individual with a positive attitude and exceptional work ethic.
• Certified Professional Coder (CPC)
• Strong proficiency of Microsoft Office (Word & Excel) or similar software is required and an ability and willingness to learn new systems and programs.
• Proficiency in medical terminology.

Preferred Qualifications

• Computer software skills (i.e., GE/IDX/EPIC), Microsoft Office Suite and E-mail, etc.).
• Medical Terminology Experience.

Competencies

Patient Facing Competencies

Minimum Proficiency Level

Accountability & Self-Management

Level 3 - Intermediate

Adaptability to Change & Learning Agility

Level 2 - Basic

Communication

Level 2 - Basic

Customer Service & Patient Centered

Level 3 - Intermediate

Emotional Intelligence

Level 2 - Basic

Problem Solving & Decision Making

Level 3 - Intermediate

Productivity & Time Management

Level 3 - Intermediate

Teamwork & Collaboration

Level 2 - Basic

Quality, Patient & Workplace Safety

Level 3 - Intermediate

Leadership Competencies

Minimum Proficiency Level

Business Acumen & Vision Driver

Level 1 - Introductory

Performance Management

n/a

Innovation & Organizational Development

Level 1 - Introductory