Accounts Receivable, Certified Professional Coder
: Job Details :

Job Type: Officer of AdministrationRegular/Temporary: RegularHours Per Week: 35Standard Work Schedule: 9AM-5PM, M-FSalary Range: $65,000.00-$75,000.00The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to departmental budgets, qualifications, experience, education, licenses, specialty, and training. The above hiring range represents the University's good faith and reasonable estimate of the range of possible compensation at the time of posting.Position SummaryThe Certified Professional Coder (CPC) is responsible for accurate coding of medical records and claims within the Clinical Revenue Office's Accounts Receivable department. This role ensures compliance with payer regulations, supports denial resolution, and contributes to efficient revenue cycle operations. The CPC plays a vital role in ensuring proper billing and reimbursement while maintaining high standards of compliance and accuracy.ResponsibilitiesAccounts Receivable Coding

Research root causes of claim denials and apply knowledge of payer policies to determine the appropriate course of action, including appeals.

Manage complex coding-related cases and recommend resolutions while escalating issues when necessary.

Prepare and review correspondence with insurance companies, patients, or guarantors to address claim-related inquiries.

Document all actions and findings in the billing system to maintain accurate and comprehensive account records.

Collaborate with senior leadership to address unresolved or escalated issues.Coding and Charge Review

Review charges in work queues for compliance and accuracy, ensuring alignment with Current Procedural Terminology (CPT), ICD-10, and other coding standards.

Perform reconciliation of charges against appointment reports or procedure logs to ensure all patient services are billed appropriately.

Verify the accuracy of charge header information, including service provider, billing area, CPT codes, modifiers, and diagnosis linkage.

Communicate with providers to resolve discrepancies via Epic or a secure chat.

Review charge correction requests and ensure accuracy prior to resubmission.Denials Management

Collaborate with Accounts Receivable staff to resolve denied or rejected claims related to coding issues.

Provide expertise in payer-specific coding requirements to facilitate successful appeals and payment recovery.

Track trends in denials and recommend process improvements to reduce future errors.Insurance Verification and Compliance

Conduct thorough insurance verification to ensure accurate claim submission and timely reimbursement.

Update patient accounts with corrected demographic or insurance information as necessary.

Ensure compliance with organizational and regulatory coding standards, including HIPAA and Medicare/Medicaid guidelines.Continuous Improvement

Monitor key performance indicators and participate in performance improvement initiatives.

Provide coding expertise to support department goals and enhance revenue cycle operations.Compliance & Other

Perform other tasks and assume additional responsibilities within the Revenue Cycle Department as assigned.

Represent the FPO Clinical Revenue Office on cross-functional committees, task forces, and work groups as assigned.

Conform to all applicable HIPAA, Billing Compliance, and safety policies and guidelines.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

Bachelor's Degree or an equivalent combination of education and experience.

A minimum of 3 years of medical coding experience, preferably in a physician billing or third-party payer environment.

An equivalent combination of education and experience may be considered.

CPC certification is required.

Proficiency in CPT, ICD-10, and HCPCS coding, as well as payer-specific billing guidelines.

Strong working knowledge of managed care eligibility, referrals, and authorizations.

Demonstrated ability to interpret clinical documentation and ensure compliance with coding and billing standards.

Excellent organizational skills and attention to detail with the ability to handle multiple tasks effectively.

Proficiency in Microsoft Office (Word, Excel) and electronic health record systems (e.g., Epic).

Must successfully complete systems training requirements.Preferred Qualifications

Experience in a physician practice or healthcare setting.

Experience in EPIC.

Familiarity with quantitative and qualitative data analysis related to coding and billing.CompetenciesPatient Facing Competencies

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 3 - Intermediate

Problem Solving & Decision Making - Level 3 - Intermediate

Productivity & Time Management - Level 3 - Intermediate

Teamwork & Collaboration - Level 2 - Basic

Quality, Patient & Workplace Safety - Level 3 - IntermediateLeadership Competencies

Business Acumen & Vision Driver - Level 1 - Introductory

Performance Management - Level 1 - Introductory

Innovation & Organizational Development - Level 1 - IntroductoryEqual Opportunity Employer / Disability / VeteranColumbia University is committed to the hiring of qualified local residents. #J-18808-Ljbffr