Reimbursement Analyst Chargemaster/Projects Corporate 42nd Street-Full-Time Days- Hybrid
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Description Reimbursement Analyst Chargemaster/Projects Corporate 42nd Street-Full-Time Days- Hybrid The Reimbursement Analyst initiates systems to capture all inpatient and outpatient charges. Monitors managed care, commercial and federal contracts to assure the recovery of all inpatient and outpatient charges in accordance with established fee schedules and ensures compliance with Medicare and other insurance carrier guidelines. Responsibilities Responsible for resolving coding related errors and/or denials identified by CDM edits or by the Billing Dept. Review documentation associated with accounts reside in Epic work queues to determine the appropriate charge/s, procedure and/or diagnosis codes. Liaison with front end, as needed, to ensure that visits are registered correctly Ensure that documentation supports charges on claim to prevent denials/underpayments and are in adherence with compliance standards and credible coding sources Assist PFS with analyzing coding denials and writing appeals, as needed. Review and distribute coding-related articles to clinical staff, including medical necessity policies and coding/billing information for various procedures Research and identify missing device &/or drug related charges that's required to support procedure on claim & bring to manger's attention for needed follow-up Identify and assists with documentation gaps in retrospect of CMS, AHA or AMA guidelines for revenue enhancement opportunities Identify patterns, trends, and opportunities for charge capture and revenue enhancement. Update charges in Eagle as required by posting and deleting and ensure that the correct info is entered to avoid negative charges or incorrect DOS. Assists /perform special projects related to re-billing or charge master activities. Participate in education programs to maintain up to date coding skills. Qualifications Bachelor?s degree or equivalent work experience required 3-5 years of multispecialty coding experience in AmSurg and/or clinic settings Proficient in Epic Billing and have thorough working knowledge of ICD-10 diagnosis coding guidelines, CPT/HCPCS code assignments. Knowledge of the Outpatient Prospective Payment System (OPPS) Ability to concentrate and accomplish tasks with explicit accuracy and established/maintained effective working relationships as required by the duties of the position. Functional knowledge of facility EMR, encoder, and other support software Detailed knowledge and understanding of hospital vs. professional charging and coding. Non-Bargaining Unit, 506 - Chargemaster/Projects - MSH, Mount Sinai Hospital Employer Description Strength Through Diversity The Mount Sinai Health System believes that diversity, equity, and inclusion are key drivers for excellence. We share a common devotion to delivering exceptional patient care. When you join us, you become a part of Mount Sinai's unrivaled record of achievement, education, and advancement as we revolutionize medicine together. We invite you to participate actively as a part of the Mount Sinai Health System team by: Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach their potential. Serving as a role model confronting racist, sexist, or other inappropriate actions by speaking up, challenging exclusionary organizational practices, and standing side-by-side in support of colleagues who experience discrimination. Inspiring and fostering an environment of anti-racist behaviors among and between departments and co-workers. At Mount Sinai, our leaders strive to learn, empower others, and embrace change to further advance equity and improve the well-being of staff, patients, and the organization. We expect our leaders to embrace anti-racism, create a collaborative and respectful environment, and constructively disrupt the status quo to improve the system and enhance care for our patients. We work hard to create an inclusive, welcoming and nurturing work environment where all feel they are valued, belong and are able to advance professionally. Explore more about this opportunity and how you can help us write a new chapter in our history! About the Mount Sinai Health System: Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients' medical and emotional needs at the center of all treatment. The Health System includes approximately 7,400 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high Honor Roll status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report's Best Children's Hospitals ranks Mount Sinai Kravis Children's Hospital among the country's best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 14 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's The World's Best Smart Hospitals ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally. The Mount Sinai Health System is an equal opportunity employer. We comply with applicable Federal civil rights laws and does not discriminate, exclude, or treat people differently on the basis of race, color, national origin, age, religion, disability, sex, sexual orientation, gender identity, or gender expression. We are passionately committed to addressing racism and its effects on our faculty, staff, students, trainees, patients, visitors, and the communities we serve. Our goal is for Mount Sinai to become an anti-racist health care and learning institution that intentionally addresses structural racism. EOE Minorities/Women/Disabled/Veterans Compensation The Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $58661 - $81675 Annually. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.Bachelor?s degree or equivalent work experience required 3-5 years of multispecialty coding experience in AmSurg and/or clinic settings Proficient in Epic Billing and have thorough working knowledge of ICD-10 diagnosis coding guidelines, CPT/HCPCS code assignments. Knowledge of the Outpatient Prospective Payment System (OPPS) Ability to concentrate and accomplish tasks with explicit accuracy and established/maintained effective working relationships as required by the duties of the position. Functional knowledge of facility EMR, encoder, and other support software Detailed knowledge and understanding of hospital vs. professional charging and coding. Non-Bargaining Unit, 506 - Chargemaster/Projects - MSH, Mount Sinai HospitalResponsible for resolving coding related errors and/or denials identified by CDM edits or by the Billing Dept. Review documentation associated with accounts reside in Epic work queues to determine the appropriate charge/s, procedure and/or diagnosis codes. Liaison with front end, as needed, to ensure that visits are registered correctly Ensure that documentation supports charges on claim to prevent denials/underpayments and are in adherence with compliance standards and credible coding sources Assist PFS with analyzing coding denials and writing appeals, as needed. Review and distribute coding-related articles to clinical staff, including medical necessity policies and coding/billing information for various procedures Research and identify missing device &/or drug related charges that's required to support procedure on claim & bring to manger's attention for needed follow-up Identify and assists with documentation gaps in retrospect of CMS, AHA or AMA guidelines for revenue enhancement opportunities Identify patterns, trends, and opportunities for charge capture and revenue enhancement. Update charges in Eagle as required by posting and deleting and ensure that the correct info is entered to avoid negative charges or incorrect DOS. Assists /perform special projects related to re-billing or charge master activities. Participate in education programs to maintain up to date coding skills.