Title: Medical Coding Specialist Lead Location: Upper East Side Org Unit: Pediatrics Work Days: Weekly Hours: 35.00 Exemption Status: Exempt Salary Range: $74,300.00 - $83,000.00 *As required under NYC Human Rights Law Int 1208-2018 - Salary range for this role when Hired for NYC Offices **Position Summary** Under supervision, assists in the development and evolution of the overall strategy for the department’s coding operations This role is also responsible for reviewing medical records for compliance with coding and documentation requirements **Job Responsibilities** + Composes and maintains billing and/or billing compliance associated correspondence. Determines proper account resolution and/or adjustment as needed. + Performs charge entry and/or payment posting within the practice management billing system as needed. Tracks and resolves issues on denied claims. Resubmits or appeals claims as required. Escalates more complex claim issues when necessary. + Attends workshops, seminars and/or conferences to keep abreast of standards and best practices within the field. Disseminates information to colleagues and/or staff as appropriate. + Analyzes coding activities and recommends systemic changes. Facilitates approved changes. + Meets regularly with clinical faculty and leadership to review compliance audit results, to ensure compliance with internal and external policies and regulations. + Conducts prospective coding reviews of outpatient, inpatient and procedure documentation to ensure that the documentation supports the services billed and all documentation standards are met. + Reviews findings of chart reviews with individual providers and recommends appropriate coding corrections. + Addresses and resolves coding errors. + Educates providers about coding changes and new compliance policies and regulations. + Updates demographics and insurance information within the practice management system. + Verifies eligibility prior to claim submission. + Tracks compliance errors. + Actively monitors employee performance and escalates issues or concerns. + Develops routine and ad hoc reports, spreadsheets and databases analyzing and summarizing billing information. + Ensures compliance with regulatory audits/inspections and/or internal reviews. Develops and recommends corrective action plans to address deficiencies identified. May serve as liaison to audit team(s) during on-site visits. **Education** + High School Diploma **Experience** Approximately 3 years of experience in physician billing and coding **Knowledge, Skills and Abilities** + Prior experience working with an eMR system. + Working knowledge of federal and state reimbursement regulations. + Knowledge of third party insurance billing policies and procedures. **Licenses and Certifications** + Certified coder (CPC, CCS-P) **Working Conditions/Physical Demands** Standard office work Weill Cornell Medicine is a comprehensive academic medical center that is committed to excellence in patient care, scientific discovery, and the education of future physicians and scientists in New York City and around the world. Our doctors and scientists - faculty from Weill Cornell Medical College, Weill Cornell Graduate School of Medical Sciences, and the Weill Cornell Physician Organization - are engaged in world-class clinical care and cutting-edge research that connect patients to the latest treatment innovations and prevention strategies. Located in the heart of the Upper East Side's scientific corridor, Weill Cornell Medicine's powerful network of collaborators extends to its parent university Cornell University; to Qatar, where an international campus offers a U.S. medical degree; and to programs in Tanzania, Haiti, Brazil, Austria and Turkey. Our medical practices serve communities throughout New York City, and our faculty provide comprehensive care at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian/Lower Manhattan Hospital, NewYork-Presbyterian Hospital/Brooklyn Methodist Hospital, NewYork-Presbyterian Hospital/Westchester Behavioral Health Center, and NewYork-Presbyterian/Queens. At Weill Cornell Medicine, we work together to treat each individual, not just their conditions or illnesses, as we strive to deliver the finest possible care for our patients - the center of everything we do. Weill Cornell Medicine is an Equal Employment Opportunity Employer. Weill Cornell Medicine provides equal employment opportunities to all qualified applicants without regard to protected status, including race, sex, sexual orientation, gender identity, national origin, color, age, religion, protected veteran or disability status, or genetic information.