5 days old

Revenue Cycle Spec-Revenue Integrity

Weill Medical College of Cornell University
New York, NY 10007
Apply Now
Apply on the Company Site
Position Summary

Performs extensive follow\-up to investigate and resolve payment denials and trends\.

Job Responsibilities

+ 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\.

+ Develops standardized approaches for operational issues, reporting & quality management\. Focuses on interface/system issues to improve data flow; overcoming invalid denial trends, payer specific carrier submission requirements & 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\.

+ Researches and interprets payer contract terms and compiles necessary supporting documentation templates for appeals according to various payer claim guidelines\.

+ Reviews accounts receivable for discrepancies\.

+ Ensures denial reviews are conducted in a timely manner & in accordance with Centers for Medicare & Medicaid Services \(CMS\) & other third party payers, reimbursement & coding regulations including the institutional and departments compliance plans\.

+ Maintains up\-to\-date policies and procedures and knowledge related to managed care and third party payors\.

+ Participates in annual and on\-going mandatory compliance training\. Fulfills Continuing Education Units necessary to maintain certification status\.

+ Remains abreast of changes in policy by reviewing regular Medicare bulletins and other relevant resources\.

+ Attends billing workshops and seminars and keeps abreast of billing policies and procedures\.

+ Assists in training current and new employees on the use of systems and departmental policies and procedures\.

+ Utilizes Microsoft Excel and other reporting software to sort, filter, summarize and identify various account receivable trends\.

+ Generates reports for analysis\.

+ Performs other related duties as assigned\.


+ Bachelor's Degree in related field


Certified Professional Coder \(CPC\) or equivalent required; or

must obtain certification within the first year\.

Approximately 3\-5 years of physician billing experience, specifically accounts receivable and collection experience\.

Prior experience working with an eMR system\.

Demonstrated knowledge of medical terminology\.

Knowledge of third party reimbursement\.

Knowledge, Skills and Abilities

+ Demonstrated ability to function independently and exercise independent judgment\.

+ Demonstrated strong communication and interpersonal skills; demonstrated ability to interact with multiple constituencies and exercise "people skills"\.

+ Demonstrated proficiency with MS Office Suite and database applications\.

+ Demonstrated organizational skills and ability to pay close attention to detail\.

+ Demonstrated critical thinking and analytical skills\.

+ Demonstrated ability to multi\-task and prioritize in a fast\-paced environment\.

+ Demonstrated ability to remain focus despite frequent interruptions\.

+ Ability to treat confidential information with utmost discretion\.

+ Ability to exercise standards of professionalism, including appearance, presentation and demeanor\.

+ Demonstrated ability to work effectively in a collaborative manner with all departmental faculty and staff, as well as other institutional representatives\.

Licenses and Certifications

+ Certified Professional Coder Certificate \(CPC\)

Working Conditions/Physical Demands

Weill Cornell Medicine is a comprehensive academic medical center that's committed to excellence in patient care, scientific discovery, and the education of future physicians in New York City and around the world\. Our doctors and scientists\-faculty from Weill Cornell Medical College, Weill Cornell Graduate School of Medical Sciences, and the Weill Cornell Physician Organization\-are engaged in world\-class clinical care and cutting\-edge research that connect patients to the latest treatment innovations and prevention strategies\. Located in the heart of the Upper East Side's scientific corridor, Weill Cornell Medicine's powerful network of collaborators extends to its parent university Cornell University; to Qatar, where an international campus offers a U\.S\. medical degree; and to programs in Tanzania, Haiti, Brazil, Austria and Turkey\. Our medical practices serve communities throughout New York City, and our faculty provide comprehensive care at NewYork\-Presbyterian Hospital/Weill Cornell Medical Center, NewYork\-Presbyterian/Lower Manhattan Hospital, and NewYork\-Presbyterian/Queens\. At Weill Cornell Medicine, we work together to treat each individual, not just their conditions or illnesses, as we strive to deliver the finest possible care for our patients \- the center of everything we do\. Weill Cornell Medicine is an Equal Employment Opportunity Employer\. Weill Cornell Medicine provides equal employment opportunities to all qualified applicants without regard to race, sex, sexual orientation, gender identity, national origin, color, age, religion, protected veteran or disability status, or genetic information\.
Posted: 2019-09-10 Expires: 2019-10-11

Before you go...

Our free job seeker tools include alerts for new jobs, saving your favorites, optimized job matching, and more! Just enter your email below.

Share this job:

Revenue Cycle Spec-Revenue Integrity

Weill Medical College of Cornell University
New York, NY 10007

Join us to start saving your Favorite Jobs!

Sign In Create Account