Billing Compliance Specialist

Job description

Title: Billing Compliance Specialist Location: Midtown Org Unit: The Office of Compliance Work Days: Weekly Hours: 35.00 Exemption Status: Exempt Salary Range: $79,400.00 - $90,200.00 *As required under NYC Human Rights Law Int 1208-2018 - Salary range for this role when Hired for NYC Offices Position Summary Monitors physician billing activity for compliance and audit feedback processes. Job Responsibilities Tracks and trends results of audits. Prepares and presents reports on results. Analyzes physician coding patterns and other documentation utilizing electronic databases. Assists in orienting new employees/faculty to departmental billing and compliance policies and procedures and notifies new employees/faculty of upcoming compliance training workshop dates. Monitors coding and medical record documentation compliance with federal and state regulations. Educates clinical staff and providers on compliant coding for maximum revenue. Designs audit tools and methodology for conducting audits. Conducts prospective and retrospective compliance documentation audits. Maintains integrity of electronic and hard copy files and databases. Researches and educates providers on appropriate coding for provider specialty. Trains as necessary on coding/documentation changes implemented internally and by insurance carriers. Monitors effectiveness of corrective action plans. Evaluates current compliance plan, makes recommendations for changes, and implements and executes new policies and procedures. 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. Identifies trends in revenue cycle activities, including payments, denials, billing, coding and/or documentation errors. Recommends actions plans to address deficiencies. Monitors implementation of corrective action plans. Education Bachelor's Degree in related field Experience Approximately 2-3 years of experience in medical records and/or physician billing Approximately 1-2 years of experience as medical coder Knowledge, Skills and Abilities Demonstrated knowledge of professional billing, including physician billing, reimbursement, and carrier relations. Demonstrated knowledge of third party reimbursement. Licenses and Certifications Certified Professional Coder Certificate (CPC) Working Conditions/Physical Demands Standard office work Cornell welcomes students, faculty, and staff with diverse backgrounds from across the globe to pursue world-class education and career opportunities, to further the founding principle of “any person, any study.” No person shall be denied employment on the basis of any legally protected status or subjected to prohibited discrimination involving, but not limited to, such factors as race, ethnic or national origin, citizenship and immigration status, color, sex, pregnancy or pregnancy-related conditions, age, creed, religion, actual or perceived disability (including persons associated with such a person), arrest and/or conviction record, military or veteran status, sexual orientation, gender expression and/or identity, an individual’s genetic information, domestic violence victim status, familial status, marital status, or any other characteristic protected by applicable federal, state, or local law. Cornell University embraces diversity in its workforce and seeks job candidates who will contribute to a climate that supports students, faculty, and staff of all identities and backgrounds. We hire based on merit, and encourage people from historically underrepresented and/or marginalized identities to apply. Consistent with federal law, Cornell engages in affirmative action in employment for qualified protected veterans as defined in the Vietnam Era Veterans’ Readjustment Assistance Act (VEVRRA) and qualified individuals with disabilities under Section 503 of the Rehabilitation Act. We also recognize a lawful preference in employment practices for Native Americans living on or near Indian reservations in accordance with applicable law.