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Responsible for office, out-patient, and inpatient physician coding. Provides education regarding documentation requirements to improve coding quality and ensure accurate and complete capture of revenue.
Duties and Responsibilities:
- Implements and manages outpatient and provider coding process for inpatient and outpatient physician services
- Validates and determines appropriate coding levels by obtaining and reviewing clinical documentation
- Compares and reviews charge tickets, both manually and system generated, to clinical documentation to ensure that all charges for procedures and related services have been accurately documented and captured
- Ensures that documentation supports charges to prevent denials/underpayments and to ensure adherence to compliance standards
- Follow-up on missing charge tickets and clinical documentation as appropriate
- Develop educational materials and policies/procedures to assist providers with the new regulatory or payer policies
- Identifies and assists with implementation of documentation and revenue enhancement opportunities
- Collaborates with clinical staff to identify and implement appropriate documentation and coding modifications
- Reviews and distributes coding related information to clinical staff, including CPT and ICD-9 code changes, medical necessity policies, coding /billing information regarding new procedures and pharmacy items
- Develops educational material and policies and procedures to assist providers with understanding new regulatory or payer policies as they relate to coding changes
- Assists in the development of fee schedule updates
- Responsible for resolving any coding related errors, edits and denials that are identified by the physician practices or practice billing system
- Consults and provides feedback with front line clinical staff, administrators and financial counselors to identify reimbursable indications for treatment
- Continuously reviews revenue cycle with management team and supervisor
- Participates in education programs to maintain up to date coding skills
- Participates with the Compliance Department in random chart audits to ensure appropriate documentation, coding and billing
- May prepare presentations for physician and staff practices as needed
- May oversee the work of less experienced staff
- Associates Degree or HS Diploma/GED plus two years of related medical coding experience
- Four years of experience in medical practice or outpatient coding
- Medical practice business office or patient accounts experience preferred
- Certified Professional Coder (CPC) preferred
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.