Senior Financial Analyst, Enterprise CDM -Patient Financial Services-Corporate 42nd Street-Full-Time Days- Hybrid

Mount Sinai Health System•New York, NY

22d•Hybrid

About The Position

The Senior Financial Analyst, Enterprise Charge Description Master for the Mount Sinai Health System (MSHS) and the Icahn School of Medicine at Mount Sinai (ISMMS) (which includes the MSHS and the Faculty Practice Plan) combines advanced financial analysis with a strong professional healthcare revenue cycle background to ensure accurate and compliant charge capture and professional CDM compliance. The ideal candidate will possess advanced knowledge of professional charging, billing, physician fee schedules, Epic workflows and quality reporting measures. This position will report to the Director of the Enterprise CDM.

Requirements

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.

Nice To Haves

Applicable professional certification through AHIMA (CCS, CCS-P) or AAPC (CPC), preferred.

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 facilitated 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