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Northwell Health · 1 day ago

Coding Specialist (Revenue Integrity Operations)

Melville, NY

Full-time

Onsite

Entry, Mid Level

$64K/yr - $98K/yr

1+ years exp

Northwell Health is seeking a Coding Specialist in Revenue Integrity Operations to review, analyze, and resolve accounts related to coding and charging claim edits. The role involves ensuring compliance with coding regulations, coordinating with departments on charge capture, and educating staff on coding and compliance issues.

ConsultingHealth CareHealth DiagnosticsMedicalPublishing

Responsibilities

Adheres to regulations and maintains a reasonable understanding of the billing process to ensure that hospital procedures and services are properly ordered

Coordinates with ancillary departments regarding the instruction of appropriate charge capture and regulatory guidelines

Identifies front-end process improvement initiatives; monitors coding changes for governmental agencies and other payers; educates departments on coding and compliance issues

Ensures revenue codes are in compliance with the Federal Register and other regulatory agencies. Uses various coding resources, including researching availability of additional documentation to assign accurate codes

Keeps abreast of federal regulatory agencies and changes in coding and reimbursement

Involved in coding system conversion projects in which new facilities are added to coding system structure

Serves as the coding resource with charge capture knowledge during coding system departmental reviews with responsibilities including voluminous charge validation and corporate mapping of each charge by department

Operates under general guidance and work assignments are varied and require interpretation and independent decisions on course of action

Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions

Qualification

Professional Coder CertificationCoding Professional CertificationClinical Coding ExpertiseRegulatory Compliance KnowledgeProcess Improvement InitiativesCharge Capture KnowledgeMedical Record Documentation

Required

Bachelor's Degree required, or equivalent combination of education and related experience

Current Professional Coder Certification, or Current Coding Professional Certification required, plus specialized certifications as needed

1-3 years of relevant experience, required

Company

Northwell Health

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Northwell Health is New York State’s largest health care provider and private employer, with 28 hospitals, about 1,000+ outpatient facilities and more than 16,000 affiliated physicians.

Founded in 1997

Manhasset, New York, USA

10001+ employees