Top Healthcare Provider Network

The 61st Street Service Corporation, provides administrative and clinical support staff for ColumbiaDoctors. This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors’ practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specialties and subspecialties.

Job Summary:

The Certified Coder and Revenue Cycle Specialist III is responsible for the review and resolution of coding-related prebilling edits and/or rejections to ensure prompt and accurate reimbursement. This position initiates medical record review and recommends proper action. This job role will also review and analyze charge correction requests and then process any needed adjustments/edits. Follows organizational policies and procedures to ensure consistency of charge capture processes and reimbursements.

Job Responsibilities:

• Review all charges within the charge review and charge entry work queues as assigned and perform charge reconciliation against the daily DAR (Department Appointment Report/Schedule) or procedure logs to ensure all completed patients have an associated charge.
• Access each transaction and review all charge header information (service provider, billing provider, insurance classification, DOS, billing area, location, POS etc.) for accuracy, as well as CPT, diagnosis codes, modifiers, diagnosis priority and linkage to CPT codes and reviewing the provider documentation.
• Perform registration changes to insurance based on charge review edits
• Performs insurance verification to secure account prior to completing charge submission.
• Communicates with provider of record as necessary via Epic in basket messaging or secure chat.
• Resolve all correction requests.
• Request additional required supporting documentation necessary.
• Runs and reconciles missing charges via missing charge reports.
• Review pre-billing system edits and and/or claims with outstanding balances.
• Reduces accounts receivable by reviewing claims with outstanding balances.
• Research and respond to insurance coding requests.
• Assist with claim issues, including preparing coding appeals.
• Generate reports to monitor claim errors and their frequency.
• Handles customer inquiries, disputes, and complaints.
  • Escalates complaints to manager as necessary.
• Review and analyze denials and reach out to payers to settle accounts.
• Responsible for performing edits on high dollar accounts.
• Scope of responsibility may include utilizing reports to monitor volumes and overall success rates.
• Assist supervisor/manager with monitoring edit requests.
• Assists with training support of new hires.
• Provides coverage for practice and revenue cycle staff.
• Performs other job duties as required and assigned.

Job Qualifications:

• High school diploma or GED equivalent is required.
• CPC certification is required via the AAPC or AHIMA
• Candidate must have strong working knowledge of CPT and ICD coding, insurance plans and benefits, referrals, authorizations, and eligibility functions.
• The ability to understand and navigate the insurance verification process including coordination of benefits, in-depth understanding of In and Out of Network Benefits and how they relate to co-insurance and deductibles.
• Must demonstrate effective communication skills both verbally and written.
• Ability to work independently, multi-task, prioritize, and manage time effectively.
• Proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.)
• Patient financial and practice management system experience in Epic or other form of electronic billing system.
• Knowledge of medical terminology.
• Previous experience in an academic healthcare setting is preferred.

Hourly Rate Ranges: $27.88 - $37.61

Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education.

61st Street Service Corporation

At 61st Street Service Corporation we are committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a competitive comprehensive Benefit package to eligible employees; including Healthcare and various other benefits including Paid Time off to promote a healthy lifestyle.

We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.