Mount Sinai Morningside ยท 2 months ago
Senior Financial Analyst, Enterprise CDM -Patient Financial Services-Corporate 42nd Street-Full-Time Days- Hybrid
New York, NY
Full-time
Hybrid
Senior Level
$66K/yr - $99K/yr
6+ years expMount Sinai Morningside is part of one of the largest academic medical systems in the New York metro area, dedicated to delivering outstanding patient care. They are seeking a Senior Financial Analyst to manage the Professional Charge Description Master and ensure compliance with billing regulations while working collaboratively with various stakeholders.
Hospital & Health Care
Responsibilities
Build, maintain, and update the Professional Charge Description Master (CDM) with timely, and accurate revenue and CPT/HCPCS codes
Work with various stakeholders for example, HIM, billing, clinical, and IT departments to resolve billing issues, update systems, and align charging workflows
Support the implementation of new coding changes and ensure overall Professional CDM compliance
Builds new charges by reviewing, assigning, and validating appropriate codes
Supports the adherence to all Federal, State and Regulatory requirements and guidelines for the Professional Charge Description Master
Works with providers and clinical areas to ensure that the professional CDM accurately reflects the services provided
Analyzes physician service charges to ensure they align with payer regulations, Medicare/Medicaid reimbursement methodologies, and managed care contracts
Provides routine, standardized reporting to stakeholders as requested or needed
Supports the annual review of the professional charge description master which includes identifying codes which have been deleted, added or replaced; assigning specific codes when appropriate; identifying description changes; and ensuring the nomenclature reflects the procedures performed
Supports and facilitates the quarterly and annual Professional Charge Description Master updates
Develops and or maintains reports to identify various metrics as defined by leadership or needed for departmental monitoring
Utilize advanced analytics to monitor revenue cycle performance and identify trends related to denials, underpayments, and coding variances
Lead and participate in multidisciplinary revenue practice teams (RPTs) to address complex billing issues and drive improvements
Ensure adherence to coding guidelines and compliance regulations set by entities like the Centers for Medicare and Medicaid Services (CMS)
Mitigate the risk of compliance violations, audits, and potential penalties related to billing errors
Resourceful in creating or fine-tuning the processes necessary to complete the work along with the ability to organize people and activities
Challenge existing norms or courses of action to facilitate fully informed decision-making. Help institute balanced decision-making by identifying risks and opportunities
Establish and maintain strong working relationships with revenue cycle leaders, key stakeholders, and foster a strong working relationship with key strategic partners
Create feedback loops and enhancement pipelines informed by stakeholders and data
Ensure compliance with all HIPAA privacy and security standards
Conform to the established policies/ procedures/ processes/ Standards of Behavior
Performs other duties as assigned
Qualification
Required
Bachelor's degree in public health/administration, finance, business or a related field or equivalent education and experience
Six (6) plus years of progressively responsible experience working with the Professional Charge Description Master, preferably in an academic medical center
5 plus years with Epic Experience, Epic certification desirable
Strong analytical skills and proficiency in Excel and related tools
Strong knowledge of quality payment programs
Demonstrated success in a large not-for-profit/academic health system professional or multi-entity revenue cycle environment
Proficiencies: Extensive knowledge of revenue cycle processes and professional charging/billing. Extensive knowledge of code data sets, Epic edits, and reimbursement
Capacity to review, analyze and interpret managed care contracts, billing guidelines, and state and federal regulations along with facilitating to all member entities
Ability to work with and interpret detailed medical record documents and communicate effectively with physicians, nursing staff, leadership and other billing personnel
Demonstrates ability to effectively manage multiple projects
Excellent interpersonal skills and experience working with senior management and other leaders, along with the ability to communicate concepts to others
Demonstrated ability to engage in positive, powerful persuasion with individuals or groups with diverse opinions and/ or agendas, leading to outcomes that meet identified goals
Excellent verbal and written communication and organizational abilities. Accuracy, attentiveness to detail and time management skills are required
Ability to interact effectively with multidisciplinary teams, including physicians and other clinical professionals internally and externally
The ability to maintain a high level of positive energy/creativity during periods of elevated work demands
Ability to prioritize multiple objectives in a rapidly changing environment and deliver quality outcomes
Preferred
Applicable professional certification through AHIMA (CCS, CCS-P) or AAPC (CPC), preferred
Company
Mount Sinai Morningside
At Mount Sinai Morningside, we offer exceptional clinical care and research within the comfort of a neighborhood hospital known for compassion and sensitivity.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Faye Reiff-Pasarew
Deputy CMO, Associate Chief of Hospital Medicine, Assistant Professor of Internal Medicine
Lucy Xenophon, MD, MPH
Chief Transformation Officer
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