Accounts Receivable, Certified Professional Coder

Columbia UniversityParker Plaza, Fort Lee, NJ

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Position Summary

The Certified Professional Coder (CPC) is responsible for accurate coding of medical records and claims within the Clinical Revenue Office's Accounts Receivable department. This role ensures compliance with payer regulations, supports denial resolution, and contributes to efficient revenue cycle operations. The CPC plays a vital role in ensuring proper billing and reimbursement while maintaining high standards of compliance and accuracy.

Responsibilities

Accounts Receivable Coding

Research root causes of claim denials and apply knowledge of payer policies to determine the appropriate course of action, including appeals.
Manages complex coding-related cases and recommends resolutions while escalating issues when necessary.
Prepares and reviews correspondence with insurance companies, patients, or guarantors to address claim-related inquiries.
Documents all actions and findings in the billing system to maintain accurate and comprehensive account records.
Collaborates with the senior leadership to address unresolved or escalated issues.

Coding and Charge Review

Reviews charges in work queues for compliance and accuracy, ensuring alignment with Current Procedural Terminology (CPT), ICD-10, and other coding standards.

Performs reconciliation of charges against appointment reports or procedure logs to ensure all patient services are billed appropriately.

Verifies the accuracy of charge header information, including service provider, billing area, CPT codes, modifiers, and diagnosis linkage.

Communicates with providers to resolve discrepancies via Epic or a secure chat.

Reviews charge correction requests and ensures accuracy prior to resubmission.

Denials Management

Collaborates with Accounts Receivable staff to resolve denied or rejected claims related to coding issues.

Provides expertise in payer-specific coding requirements to facilitate successful appeals and payment recovery.

Tracks trends in denials and recommends process improvements to reduce future errors.

Insurance Verification and Compliance

Conducts thorough insurance verification to ensure accurate claim submission and timely reimbursement

Updates patient accounts with corrected demographic or insurance information as necessary.

Ensures compliance with organizational and regulatory coding standards, including HIPAA and Medicare / Medicaid guidelines.

Continuous Improvement

Monitors key performance indicators and participates in performance improvement initiatives.

Provides coding expertise to support department goals and enhance revenue cycle operations.

Compliance & Other

Performs other tasks and assumes additional responsibilities within the Revenue Cycle Department as assigned.

Represents the FPO Clinical Revenue Office on cross-functional committees, task forces, and work groups as assigned.

Conforms to all applicable HIPAA, Billing Compliance, and safety policies and guidelines.

Please note : While this position is primarily remote, candidates must be in a Columbia University-approved telework state. There may be occasional requirements to visit the office for meetings or other business needs. Travel and accommodation costs associated with these visits will be the responsibility of the employee and will not be reimbursed by the company.

Minimum Qualifications

Bachelor's Degree or an equivalent combination of education and experience.

A minimum of 3 years of medical coding experience, preferably in a physician billing or third-party payer environment.

An equivalent combination of education and experience may be considered.

CPC certification is required.

Proficiency in CPT, ICD-10, and HCPCS coding, as well as payer-specific billing guidelines.

Strong working knowledge of managed care eligibility, referrals, and authorizations.

Demonstrated ability to interpret clinical documentation and ensure compliance with coding and billing standards.

Excellent organizational skills and attention to detail with the ability to handle multiple tasks effectively.

Proficiency in Microsoft Office (Word, Excel) and electronic health record systems (e.g., Epic).

Must successfully complete systems training requirements.

Preferred Qualifications

Experience in a physician practice or healthcare setting.

Experience in EPIC.

Familiarity with quantitative and qualitative data analysis related to coding and billing.

Competencies

Patient Facing Competencies

Minimum Proficiency Level

Accountability & Self-Management

Level 3 - Intermediate

Adaptability to Change & Learning Agility

Level 2 - Basic

Communication

Level 2 - Basic

Customer Service & Patient Centered

Level 3 - Intermediate

Emotional Intelligence

Level 3 - Intermediate

Problem Solving & Decision Making

Level 3 - Intermediate

Productivity & Time Management

Level 3 - Intermediate

Teamwork & Collaboration

Level 2 - Basic

Quality, Patient & Workplace Safety

Level 3 - Intermediate

Leadership Competencies

Minimum Proficiency Level

Business Acumen & Vision Driver

Level 1 - Introductory

Performance Management

Innovation & Organizational Development

Level 1 - Introductory

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Certified Coder • Parker Plaza, Fort Lee, NJ