Coding Specialist

Position Summary

The Coding Specialist is responsible for the review and resolution of all coding related prebilling edits and/or rejections to ensure prompt and accurate reimbursement. The individual will report to the Operation Billing Manager at the Department of Surgery. This position initiates medical record review and recommends proper action. This position communicates with department clinical and billing staff regarding missing or unclear documentation.

Responsibilities

• Review and resolve all assigned tasks/encounters associated with coding discrepancies as it relates to pre­billing system edits and/or claims with outstanding balances.
• Reduces accounts receivable by reviewing claims rejected for coding. Investigates assigned accounts to determine what additional steps must be taken for claims to be resolved.
• Provide guidance and suggestions to clinical departments for pre­billing coding edits.
• Maintains patient confidentiality; complies with HIPAA and compliance guidelines established by the hospital.
• Review and follow up on denials related to coding and charge entry processes; if a claim is denied due to incorrect coding, conducts medical records research and corresponds with insurance companies and clinicians to resolve issue.
• Manages appeals with insurance companies for surgical claim reimbursement when appropriate.
• Assess clinical documentation supporting services.
• Researches and responds to insurance coding requests.
• Assists with claim issues, including preparing coding appeals.
• Serves as liaison between clinicians, billing consultants, patient financial counselor and insurance carriers to discuss coding issues.
• Maintain tracking reports when issues and trends have been identified.
• Support other functions as assigned.

Minimum Qualifications

Minimum education:

Bachelor's degree or equivalent in education and experience required.

Minimum related experience:

2 years related experience.

Other Requirements

• Must be able to successfully complete systems training requirements.

Equal Opportunity Employer / Disability / Veteran

Columbia University is committed to the hiring of qualified local residents.