Central Billing Office - Coding Integrity Specialist **Boynton Beach, FL**
Boynton Beach, FL 
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Job Description

NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, a children's hospital, three emergency rooms and a level 1 trauma center. Also part of NYU Langone Health is the , a National Cancer Institute designated cancer center, and , which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. For more information, go to nyulangone.org, and interact with us on Facebook, Twitter, YouTube and Instagram.

Position Summary:
We have an exciting opportunity to join our team as a Coding Integrity Specialist.

In this role, the successful candidate, reporting to the Coding Manager, will be responsible for analyzing, reviewing and monitoring compliance with established protocols and regulations related to the coding and billing of professional services. The position will collaborate with internal and external teams to update workflows and provide education and guidance around meeting established standards.

Job Responsibilities:

  • Prepares and presents coding materials at revenue cycle meetings
  • Assist with special projects on as-needed basis.
  • Effectively use various computer applications to conduct research, create reports and presentation material
  • Maintain collaborative relationships with internal and external teams to ensure integration and alignment of department priorities.
  • Apply critical thinking, negotiation and conflict resolution skills
  • Review, monitor, and facilitate implementation of billing and coding changes affecting charge capture processes in accordance with payer requirements.
  • Research and update new and/or revised coding and compliance standards utilizing multiple government resources including: CMS, AMA, OIG, etc.
  • Promptly report any and all potential compliance issues to leadership and the Director of Compliance if necessary
  • Independently analyze and weigh the risks verses benefits in decisions and recommendations related to provider billing and bill audit issues.
  • Provide professional coding, billing, and compliance guidance/education to offshore coding teams.
  • Develop complete reports reflecting audit findings including negative and positive trends. Reports findings to leadership and follows through as directed.
  • Objectively review and Audit clinical documentation, CPT-4, HCPCS, modifiers and ICD-10 coding to ensure accurate reimbursement and compliance with CMS and third party payer laws and regulations.

Minimum Qualifications:
To qualify you must have a Bachelors degree and 4-6 years of auditing and revenue cycle management experience in a health care environment.
Extensive knowledge of coding principles and guidelines
Knowledge of RAC process including targeted coding areas
Extensive knowledge of reimbursement systems, as well as federal, state and payer-specific regulations and policies pertaining to documentation, coding and billing.
Knowledge of Electronic Medical Records
Strong interpersonal communication and presentation skills, effectively presenting information to management, faculty practice groups and individuals
Excellent organizational and project management skills.
Strong time management, attention to detail, and follow through.
Well-developed research skills.
Strong knowledge of revenue cycle process, revenue integrity and its impact throughout the revenue cycle.

Preferred Qualifications:
Certified Coding Specialist Certification (CCS) or Certified Coding Specialist- Physician-based (CCS-P) or Certified Professional Coder (CPC), Certified Outpatient Coding (COC)

NYU Langone Florida is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.

If you wish to view NYU Langone Florida's EEO policies, please . Please to view the Federal "EEO is the law" poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information. To view the Pay Transparency Notice, please .

 

Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Bachelor's Degree
Required Experience
4 to 6 years
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