Reimbursement Analyst Chargemaster/Projects Corporate 42nd Street-Full-Time Days- Hybrid

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.

• 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.

• 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

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