Cornell University
1 - 10 employees
📚 Education
⚕️ Healthcare Insurance
🧬 Biotechnology
Education • Healthcare Insurance • Biotechnology
Cornell University is a prestigious Ivy League institution that provides a comprehensive education in various disciplines, placing a strong emphasis on research and academic excellence. It is home to Weill Cornell Medicine, which focuses on medical education, research, and patient care, contributing significantly to the fields of healthcare and biotechnology.
Revenue Cycle Specialist – Revenue Integrity, Pathology
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🔥 2 hours ago
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Cornell University
1 - 10 employees
📚 Education
⚕️ Healthcare Insurance
🧬 Biotechnology
Education • Healthcare Insurance • Biotechnology
Cornell University is a prestigious Ivy League institution that provides a comprehensive education in various disciplines, placing a strong emphasis on research and academic excellence. It is home to Weill Cornell Medicine, which focuses on medical education, research, and patient care, contributing significantly to the fields of healthcare and biotechnology.
📋 Description
• Performs retrospective coding 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. • Make corrections to charges when necessary. • Analyze for 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. • Researches and interprets payer contract terms and compiles necessary supporting documentation templates for appeals. • Ensures denial reviews are conducted in a timely manner. • 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. • Assists in training current and new employees on the use of systems and departmental policies and procedures. • Performs other related duties as assigned.
🎯 Requirements
• High school diploma or GED in related field • Certification as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certified by AHIMA or AAPC. • Approximately 3-5 years of physician billing experience, specifically accounts receivable and collection experience. • Prior experience working with an eMR system. • Knowledge of medical terminology. • Knowledge of third-party reimbursement. • Microsoft Excel and other reporting software to sort, filter, summarize, and identify various accounts receivable trends. • Pathology experience preferred.
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