Reimbursement Analyst (CCS or CPC) Coding Chargemaster/Projects Corporate 42nd Street-Full-Time Days- Hybrid

Reimbursement Analyst (CCS or CPC)  Coding  Chargemaster/Projects Corporate 42nd Street-Full-Time Days- Hybrid

The Reimbursement Analyst initiates systems to capture all inpatient and outpatient charges. Monitors managed care, commercial and federal contracts to assure the recovery of all inpatient and outpatient charges in accordance with established fee schedules and ensures compliance with Medicare and other insurance carrier guidelines.

• Assures that fee schedules, Current Procedural Terminology (CPT) and International Statistical Classification of Diseases (ICD-9) codes are accurately entered in the billing system.
• Identifies and defines appropriate CPT codes for existing and new services.  Assures that updated fee schedules for Medicare, Medicaid, commercial and managed care carriers are correctly entered in the billing system.
• Analyzes payments for high volume and high dollar procedures to assure that Medicine FPA billing is paid appropriately; analyzes payment trends to identify patterns of payment denials.
• Coordinates initiatives with the billing and collection area to initiate plans for resolving billing disputes.
• Keeps abreast of changes in Medicare and Medicaid regulations that impacts Practice and Billing Office operations.
•  Provides on-going in-service training for staff on proper coding guidelines, insurance regulations, medical records and physician documentation and signature requirements.
• Performs other related duties.

• Associate?s degree in accounting or business related field; Bachelor?s degree preferred
• 4 years of insurance billing and collection procedures in a health care environment
• Excellent written, verbal and interpersonal skills
• Demonstrated knowledge of insurance billing and collection procedures and CPT and ICD-9 coding

 

Preferred Experience:.

• 3 plus years of multispecialty coding experience in AmSurg and/or clinic settings Preferred
• Proficient in Epic Billing and have thorough working knowledge of ICD-10 diagnosis coding guidelines, CPT/HCPCS code assignments preferred 
• Knowledge of the Outpatient Prospective Payment System (OPPS) preferred
• Ability to concentrate and accomplish tasks with explicit accuracy and established/maintained effective working relationships as required by the duties of the position preferred
• Functional knowledge of facility EMR, encoder, and other support software preferred 
• Detailed knowledge and understanding of hospital vs. professional charging and coding preferred 
• AHIMA (CCS) or AAPC (CPC) approved credential preferred 

Non-Bargaining Unit, 506 - Chargemaster/Projects - MSH, Mount Sinai Hospital