Billing Specialist-MSH-78319-028

Mount Sinai; United States; On-site; USD 52,000 - 75,000; Full time

Job summary

Mount Sinai is seeking a Medical coder to review charts and ensure physician charges are captured in EPIC across inpatient and outpatient settings.

You will code encounters using CPT, ICD-9/10CM, and HCPCS, apply CCI edits, and query physicians to correct documentation. CPC/CCS-P certification and HIPAA knowledge are preferred.

The role requires at least six months coding experience, strong computer skills, and the ability to work independently with minimal supervision.

Qualifications

• High School Diploma required.
• CPC/CCS-P certification preferred or required.
• Knowledge of ICD-9/ICD-10CM and CPT-4 coding.
• Experience with HIPAA regulations and compliance.

Responsibilities

• Review medical charts and documentation to ensure physician charges are captured.
• Code patient encounters with CPT, ICD-9/10CM, and HCPCS in EPIC.
• Utilize CCI edits and Local Coverage Determinations for accuracy.
• Identify areas for documentation improvement and query physicians.
• Review edits and denials with AR to ensure timely revenue capture.
• Maintain daily logs of coded work.
• Ensure operative reports and third-party regulatory information meet coding requirements.
• Work with management and billing vendor to reduce denials.
• Attend trainings to maintain CPC certification.

Skills

Medical terminology

CPT coding

ICD-10-CM coding

HIPAA compliance

Physician queries

Independent work

Education

High School Diploma

Tools

Epic EMR

Microsoft Excel

Job description

Review Medical charts and documentation within but not limited to the facility EMR, Epic, to ensure that all Physician charges are captured in a timely and complaint manner.Work with the Faculty Practice Group Compliance Manager and Administrator to ensue all FPG revenue is captured.

Maintains a working knowledge of CPT and ICD-9/10CM coding principles, governmental regulations, protocols and third party requirements regarding coding and billing documentation.

Review and code patient encounters in EPIC with appropriate CPT, ICD-9CM, ICD-10CM and HCPCS codes for a multi-specialty group practice. Services include inpatient, outpatient, Emergency, and ambulatory surgery for both E & M encounters and procedures.

Utilizes the Correct Coding Initiative (CCI) edits for accurate assigning of code and make use of the Local Coverage Determinations for medical necessity.

Identify any areas for improvement in documentation as related to compliance and billing. Query and/or meet with physicians regarding documentation and deficiencies.

Review edits, denials and requests for additional information from the accounts receivable team to ensure the time processing of claims and all revenue is captured.

Maintains daily logs of coded work.

Assures that operative reports and other third party regulatory information are pertinent to coding requirements.

Works with management and the billing vendor daily, on edit list and/or requests for additional information as to reduce denials and accounts receivable.

Attends various classes, seminars or trainings to keeping current with CPC certification.

Reviews, modifies and recommends changes to policies and procedures to improve coding.

Performs other related duties as assigned.

Requires a level of understanding that is obtained or acquired through the completion of a High School Diploma.

Knowledge of Medical Terminology, ICD-9CM, ICD-10CM and CPT 4 coding certification obtained by completion of a certificate course with CPC / CCS-P credentials.

At least six months coding experience preferred.

Certified Professional Coder/AAPC.

Ability to use computer. Average dexterity and knowledge of software applications such as Microsoft, Excel, etc.

Ability to work independently with minimal supervision at a high level of productivity.

Ability to examine scanned documents, such as operative reports to determine accuracy of coding.

Ability to prioritize own work and proceed with minimum supervision.

Ability to maintain strictest confidentiality according to HIPAA regulations.

Ability to work effectively with others as well as physicians.

Be able to perform effectively with various commercial and hospital computer applications.