Responsible for ongoing auditing of outpatient provider coding and education, with a focus on accurate code assignment, regulatory compliance, and optimal reimbursement.
Serves as a subject matter expert in CPT, ICD-10-CM, HCPCS, New York State Medicaid, CMS, and commercial payer requirements.
Reviews and resolves billing work queues, analyzes claim denials and reimbursement trends, identifies charge capture and documentation opportunities, and supports timely claim resolution.
Partners with providers, operations, finance, and revenue cycle leadership to improve documentation quality, reduce denials, optimize reimbursement, and strengthen revenue integrity through education, Epic optimization, auditing, and continuous process improvement.
Works in a professional office environment with potential exposure to communicable diseases and other conditions in a health center setting.
High school diploma or GED required.
Five or more years of experience in outpatient provider coding, including coder certification.
Five or more years of experience in compliant provider documentation.
Three or more years of experience in Epic EMR coding, billing, and provider documentation.
Strong knowledge of CMS compliance and audit guidelines.
Proficiency with Microsoft Windows, Excel, Word, PowerPoint, and Outlook.
Knowledge of third-party payer contracts, Medicaid reimbursement, CPT-4, ICD-10 coding requirements, and carrier guidelines.
Ability to analyze data and use analytics for decision-making, performance measurement, and financial analysis.
Strong time management skills and ability to handle multiple deliverables in a high-distraction environment.
Excellent interpersonal, written, and verbal communication skills.
Ability to explain complex coding regulations to non-specialists.
Strong team-building skills and process improvement orientation.
Preferred qualification: associate degree in business.
Generous PTO and holiday schedule
Medical, dental, and vision coverage options for employees and eligible dependents
FSA, HSA, and commuter pre-tax reimbursement funds
Short- and long-term disability
Free basic life and AD&D coverage
401(k) retirement plan with safe harbor contributions after 1 year of employment
Flexible schedule during peak activity periods
Comprehensive benefits package offered by the employer
Location
New York, New York, US
Employment Type
Full-time
Experience Level
Senior
Salary Range
$70,000 - $80,000
Remote work allowed
No
Posted
1 week ago