Mount Sinai Careers
Coding Specialist (CPC) - Urology
Strength Through Diversity
Ground breaking science. Advancing medicine. Healing made personal.
Roles & Responsibilities:
Ranked among the nation’s best for Urology in the "Best Hospitals" issue of U.S. News and World Report, the physicians of Mount Sinai Urology are leaders in robotic surgery and minimally invasive procedures to treat prostate, kidney, and bladder cancers.
We emphasize comprehensive, patient-centered care and devote considerable time to discussing the potential benefits and side effects associated with each treatment with you. We encourage you to become as knowledgeable as possible about their condition so the conversation can be truly two-way. Additionally, our approach is multidisciplinary. We partner with our distinguished colleagues in other departments in the Mount Sinai Health System, including radiology, medicine, and oncology, to ensure we are providing comprehensive, personalized, and coordinated treatment.
The Coding Specialist (CS) will be responsible for the quality and accuracy of CPT and ICD-10 assignment/submission for multiple Urology providers who are in various patient settings (Inpatient, Outpatient, and Doctors Office). The CS will be responsible for feedback regarding documentation and billing guidelines to providers and front-end users. They will need to obtain a clear understanding of the department’s charge capture workflow, and assist with improvements that will directly impact the timeliness of claim submissions and their adjudication. They will work in conjunction with the Revenue Cycle Manager to maximize the department’s revenue stream.
- Manage the coding process for multiple Urology providers
- Validate and determine appropriate coding levels, procedures and diagnosis codes by obtaining and reviewing clinical documentation while following appropriate CPT and payor guidelines
- Compare and review charge tickets, both manually and system generated, to clinical documentation to ensure that all charges for office visits and procedures have been accurately documented and captured
- Ensure that documentation and coding supports billings to prevent denials and underpayments
- Follow-up with providers regarding missing clinical documentation which is required to complete accurate coding and billing
- Stays current with educational materials and policies/procedures to assist staff and providers with the new regulatory or payer policies
- Identify and assist with implementation of documentation and revenue enhancement opportunities
- Assist with the development of educational material and policies and procedures to assist providers and staff with understanding new regulatory or payer policies
- Contacts payors for AR follow-up, clarification of payor specific guidelines, and/or submit appeal/reconsiderations when needed
- In conjunction with the Revenue Cycle Manager, identify relevant charge master updates
- Responsible for resolving any coding related errors and denials that are identified by Hospital’s billing and follow-up team as part of the revenue enhancement initiatives
- Assist the Hospital billing and follow-up team with denial appeals
- Consults and provides feedback with frontline clinical staff, financial clearance team, and financial counselors to identify reimbursable indications for treatments
- Continuous review of revenue cycle with the Director and Revenue Cycle Manager
- Participates in departmental projects as needed
- Participate in education programs to maintain up to date coding skills
- Working with Revenue Cycle Manager, coordinate random chart audits to ensure appropriate documentation, coding and billing and provide feedback to key personnel.
- HS/GED required, Associates degree preferred.
- Certified Professional Coder (CPC) Certificate
- 3 years of relevant coding experience is required
- Business office or patient accounts experience a plus
- Exposure or participation in documentation improvement programs is a plus
- Excellent written and oral communication skills and computer skills are essential
- Must be organized and capable of multi-tasking various projects and developing and adjusting priorities as necessary
- Ability to prioritize the scope of work in line with the department goals
- Knowledge of CPT documentation guidelines as well as the CMS Medicare Claims Processing Manual.
Strength Through Diversity
The Mount Sinai Health System believes that diversity is a driver for excellence. We share a common devotion to delivering exceptional patient care. Yet we’re as diverse as the city we call home- culturally, ethically, in outlook and lifestyle. 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 work hard to acquire and retain the best people, and to create a welcoming, nurturing work environment where you can develop professionally. We share the belief that all employees, regardless of job title or expertise, can make an impact on quality patient care.
Explore more about this opportunity and how you can help us write a new chapter in our story!
Over 38,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.
Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospital campuses, including Mount Sinai Beth Israel, Mount Sinai Beth Israel Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai St. Luke’s, and New York Eye and Ear Infirmary of Mount Sinai.
The Mount Sinai Health System is an equal opportunity employer. We promote recognition and respect for individual and cultural differences, and we work to make our employees feel valued and appreciated, whatever their race, gender, background, or sexual orientation.