Reimbursement Specialist CPC - Surgery
Company: Albany Medical Center
Posted on: January 27, 2023
Day (United States of America)
The Reimbursement Specialist- CPC is responsible for correct
coding, charge entry and reimbursement/denial follow up tasked by
their team lead. This position will code clinical and
procedural/surgical CPT and ICD-10-CM diagnosis for professional
charges and review charges and documentation supplied by providers
and medical staff to ensure they are compliant with federal and
state regulations and laws as well as other insurance carrier
guidelines. Timely and accurate completion of day-to-day processing
of all clinic and procedural coding and charge entry for multiple
This position will assist the team lead in serving as the Practice
Coding Operations liaison between the assigned Departments and
MCPG. Must be efficient with electronic medical records and
knowledgeable of various insurance company billing policies and
procedures. Must have ability to work with minimum-to-moderate
direct supervision and as a team player with other practice staff
GENERAL DUTIES (to include but not limited to):
- Must be able to adapt to a large, complex, multi-system
business environment, confer with both internal and external
customers and vendors and assist in managing the expectations of a
diverse and demanding User constituency.
- Work with the team lead within assigned departments to support
and streamline day to day workload.
- Must have extensive knowledge of clinic and procedure based
- Assist in creating and updating policies and procedures to be
used within the designated departments.
- Work department reports and assigned work queues and bring
feedback to coding team lead to ensure proper coding and avoid
future delays in payment.
- Work with minimal supervision on assignments.
- Identify any coding or payer changes and bring that information
to the team lead and providers to ensure proper coding.
- Supports development tools, procedures and methods for daily
- Works with the team lead on routine, well defined, analysis
type problems related to coding and reimbursement.
- Fulfills department requirements in terms of providing work
coverage and administration notification during periods of
personnel illness, vacation or education.
- Maintain HIPAA confidentiality at all times.
- Other duties or assignments as designated by management.
- Certified Professional Coder (CPC). Must be a member in good
standing of the American Academy of Professional Coders and
maintain biannual continuing education credits (36) to solidify
up-to-date knowledge and understanding of professional medical
- Certificate of ICD-10-CM Proficiency for diagnosis coding is
- Apply correct coding guidelines to multiple source system
entries for coding and charge entry.
- Timely and accurate completion of day-to-day processing of all
clinic and procedural coding and charge entry for multiple
- Assist team lead in defining and submitting RCx rules for
consideration to streamline coding accuracy and efficiency within
multiple interfaced systems.
- Knowledge of insurance, managed care, Medicaid and Medicare
- Strong attention to detail and critical thinking skills.
- Strong organizational and time management skills.
- Assist in data analysis and development of logical solutions to
coding and reimbursement problems
- Interface effectively and cooperatively with computer system
and their Users to maintain efficient system utilization; recommend
appropriate revisions to processes, procedures, and
- Assist with testing and implementation of third-party vendor
- Ability to work well with people from different disciplines
with varying degrees of business and technical expertise.
- Good interpersonal relationship skills.
Thank you for your interest in Albany Medical Center!---
Albany Medical is an equal opportunity employer.
This role may require access to information considered sensitive to
Albany Medical center, its patients, affiliates, and partners,
including but not limited to HIPAA Protected Health Information and
other information regulated by Federal and New York State statutes.
Workforce members are expected to ensure that:
Access to information is based on a "need to know" and is the
minimum necessary to properly perform assigned duties. Use or
disclosure shall not exceed the minimum amount of information
needed to accomplish an intended purpose. Reasonable efforts,
consistent with Albany Med Center policies and standards, shall be
made to ensure that information is adequately protected from
unauthorized access and modification.
Albany Med is the centerpiece of medicine, research, and medical
education in New York's CapitalRegion and is the area's largest
private employer with more than 10,000 employees.
Albany Med offers excellent career opportunities in a wide range of
roles in both patient care andadministration. We value all our
staff members and offer outstanding employee benefits
- Excellent health care coverage ( with lower copays at most
Albany Med providers.
- A wide array of services and programs to support emotional,
physical, and mental wellbeing (
Anchored in the state's historic capital city, Albany Med offers a
full range outpatient and inpatient careand is home to the region's
largest hospital, only Level 1 trauma center, and only children's
hospital. Thedowntown campus also offers opportunities at Albany
Albany Med partners with Columbia Memorial Health, Saratoga
Hospital and Glens Falls Hospital to form the Albany Med Health
System, serving more than three million people over 25
Keywords: Albany Medical Center, Albany , Reimbursement Specialist CPC - Surgery, Other , Albany, New York
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