Reimbursement Analyst (CPC Certified)

Job Description

Strength Through Diversity
Ground breaking science. Advancing medicine. Healing made personal.
Finance – Req. 79113
Job Title: Reimbursement Analyst
Roles & Responsibilities: 
Monitors managed care, commercial and federal contracts to assure that services are reimbursed in accordance with established fee schedules.  Also monitors federal and state regulations to identify policies that will impact practice and billing office operations, and managed care guidelines are monitored for compliance.  Additionally, this position oversees the centralized credentialing function.  Reports to the Director of Faculty Practices for the Department of Medicine and provides analytical support to Medicine FPA Billing.
  • Assures that CPT and ICD-9 codes are accurately entered in the billing system.          
  • Assures that updated fee schedules for Medicare, Medicaid, commercial and managed care carriers are correctly entered into the billing system.
  • Analyzes payments for high volume and high dollar procedures to assure that Medicine FPA Billing is paid appropriately.    
  • Coordinates initiatives to resolve billing disputes with payors regarding appropriate payment.       
  • Analyzes payment trends to identify patterns of payment denials by payor or provider.            
  • Monitors credentialing and recredentialing initiatives to assure that providers are being credentialed timely; intervenes with payors credentialing departments to facilitate credentialing as necessary.    
  • Monitors changes in Medicare and Medicaid regulations that could impact on Practice and Billing Office operations.         
  • Coordinates updates to Practice and Billing Office staff on updates and assists in initiatives to revise operations to comply with new rules and regulations.        
  • Maintains a master fee schedule for the Department of Medicine; assures that fees are assigned to new procedures in accordance with accepted standards.
  • Associate’s degree in health care or business related field; Bachelor’s degree preferred
  • 1-2 years medical coding experience
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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