Shire Jobs

JOB DESCRIPTION

Under general supervision, reviews, analyzes and assures the final diagnoses and procedures as stated by the practicing providers are valid and complete.

Accurately codes office and hospital procedures for providers to ensure proper reimbursement. Provides education to the providers to ensure proper completion of medical records (EMR) and proper assignment of billing codes (ICD10, CPT, modifiers, etc.).

RESPONSIBILITIES

• Under supervision, identify and resolve coding related edits by reviewing the medical record and ensuring that all data and codes are consistent with guidelines

• Responds to billing staff inquiries regarding denials received for coding issues in a timely manner.

• Supplies correct ICD10 diagnosis codes

• Supplies correct HCPCS code on all procedures and services performed

• Supplies correct CPT code on all procedures and services performed

• Properly bill/codes professional services for hospital-based procedural services

• Audits records to ensure proper submission of services prior to billing on pre-determined selected charges

• Follow-up with providers regarding missing clinical documentation which is required to complete accurate coding and billing

• Contacts providers to train and update them with correct coding information

• Develop 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.

• Review and distribute coding related information to clinical and financial staff, including CPT and ICD-10 code changes, medical necessity policies, coding/billing information regarding new procedures and pharmacy items.

• Audits medical records to ensure proper coding completed and to ensure compliance with federal and state regulatory bodies

• Identifies and reports edit trends to provide feedback for improved documentation and revenue cycle

• Acts as a resource person to other departments regarding coding questions and issues.

• Reports compliance problems appropriately.

• Consistently supports the precepts of Corporate Compliance and the Principles of Responsibility by maintaining confidentiality, protecting the assets of the organization, acting with integrity, reporting observed fraud and abuse and complying with applicable state, federal and local laws and program policies and procedures.

• Assist revenue Cycle Team with charge entry, registration and customer service edits, missing charges, etc. as needed.

• Performs other related duties, which may be inclusive, but not listed in the job description

QUALIFICATIONS

• Minimum: High School; Preferred: Bachelor's;

• Certificate or associate's degree in medical coding or a related field

• Minimum of three (3) years’ experience

• Academic practice experience preferred

• Strong leadership and analytical skills

• Strong customer service skills

• Ability to communicate effectively with clinical, business and administrative staff

• Excellent written and oral communication skills

• Exceptional attention to detail and accuracy

Computer Skills

• WORD Intermediate

• EXCEL Intermediate

• Microsoft Access Beginner

• Outlook Intermediate

• EMR - EPIC

REQUIRED SKILLS

Microsoft Office Suite

ABOUT US

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 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,400 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 14 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.

The Mount Sinai Health System is an equal opportunity employer. We comply with applicable Federal civil rights laws and does not discriminate, exclude, or treat people differently on the basis of race, color, national origin, age, religion, disability, sex, sexual orientation, gender identity, or gender expression. We are passionately committed to addressing racism and its effects on our faculty, staff, students, trainees, patients, visitors, and the communities we serve. Our goal is for Mount Sinai to become an anti-racist health care and learning institution that intentionally addresses structural racism.”

EOE Minorities/Women/Disabled/Veterans

Requisition ID : 3014148