Revenue Cycle Manager, Patient Financial Services

Job Description

Strength Through Diversity
Ground breaking science. Advancing medicine. Healing made personal. 
Patient Financial Services - REQ # 2354458
Job Title: Revenue Cycle Manager, Patient Financial Services
Roles & Responsibilities:
Under the direction of the Vice President of Patient Financial Services responsibilities will include monitoring, analyze, troubleshoot and correct of any new billing regulations, new denial(s), charge posting process and new regulations as it involves the PFS department for the Mount Sinai Hospital and Mount Sinai Queens Hospital. Monitoring of our investigation/study accounts, denials including non-covered and all new service lines implemented. Responsible for the monitoring of all un-coded and open accounts for the Medical Records, Revenue Mid Cycle and Front End Area’s. Responsible for monitoring the PFS Billing Compliance Program, the RCTF agenda’s and summarizing all unbilled accounts by reason. Responsible for the monitoring of the Audit and Eligibility activity. Can function as liaison between hospital and front-end Hospital departments.
  • Research and deliver new billing service(s) and guidelines.
    Monitor and correct denials
  • Identify, analyze and correct account issues via system queries, ex charge postings, financial class
  • Provide financial increase/decrease on new regulations
  • Monitor and prepare monthly grids
  • Oversee the PFS Billing Compliance Program; responsible for updating of new policies
  • Analyze Audits received
  • Troubleshoot unpaid/billed rejected accounts and correct.
  • Analyze Audits and provide findings
  • Understand the functionality of all systems within the revenue cycle process for PFS
  • Understand Inpatient and Outpatient Article 28 Billing and regulations
  • Understand Hospital Financial Insurance rules as it applies to Inpatient/Outpatient Article 28
  • Understand various coding rules for the various payers for Inpatient and Outpatient Article 28.
  • Work with Senior PFS Management to develop and implement new procedures to improve the quality and quantity of work processed.
  • Monitors daily operating activity of assigned PFS Unit and makes suggestions necessary for improved work flow and efficiency.
  • Initiates and responds to pertinent correspondence. Prepares operational and financial reports and analysis, noting progress as well as adverse trends. Makes appropriate recommendations or conclusions. Maintains records and files.
  • Maintains knowledge and complies with established policies and procedures including government, insurance and third-party payer regulations.
  • Attends administrative meetings and participates on committees as requested. Conducts special projects and studies, as directed.
  • Maintains confidentiality as regards patient account status.
  • Assists in the planning of short and long-range goals for the department, unit or division. Prepares and evaluates proposals to implement new programs and expand existing ones.
  • Other relevant duties as assigned.

  • Bachelor’s degree in health administration, health information, management or business administration helpful and/or 5-7 years in Hospital Billing required.
  • Understanding of CPTs, HCPCS, APCs, DRGs and OPPS required. Coding certificate/licensure preferred.
  • 7+ years of Hospital Billing required.

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! 
Who We Are
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. 
EOE Minorities/Women/Disabled/Veterans
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