AddressThe Billing Specialist is responsible for multiple components of the billing & coding process, including Accounts Receivable, Charge Entry, Edits and Payment Posting. Proficient in these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution.
Responsibilities
- Enters office, inpatient, and/or outpatient charges with accurate data entry of codes. Ensures charges are entered/processed in accordance with policies and procedures.
- Extract CPT codes form operative reports and reconcile with the providers bill, to make sure the providers a coding optimally.
- Collaborate with other coders and provide education/feedback to the providers on optimal billing and coding for outpatient encounters, in-patient consults and procedures/surgeries.
- Provide orientation to the new providers about relevant billing and coding for neurosurgical encounters
- Run reports for missing charges and collaborate with providers/practices to ensure timely charge entry.
- May run and work missing charges, edits, denials list and process appeals. Posts denials in EPIC/IDX on a timely basis.
- Posts all payments in IDX using approved methodologies.
- May perform specialty coding for services and medical office visits and review physician coding and provide updated to physicians and staff.
- Works TES, BAR and eCommerce edits for the division, department and physicians. Proficient in moderate to complex encounters and problematic accounts.
- Works daily Accounts Receivable accounts via online workfile and/or hard-copy reports; checks claims status, re-submits claims, and writes appeal letters.
- Researches unidentified checks sent to other departments.
- Works credit balance report to ensure adherence to government regulations/guidelines.
- Analyzes claims system reports to ensure underpayments are correctly identified and collected from key carriers. Reviews and resolves billing issues and provides recommendations.
- Identifies and resolves credentialing issues for department physicians.
- Meets with practice management, leadership and/or physicians on a scheduled basis to review Accounts Receivable and current billing concerns.
- Mentors less experienced Billing staff and assists Billing Manager/FPA Manager in training new staff.
- May approve EPIC work queue for outpatient encounters.
- Verifies insurance and registration data for scheduled office, outpatient, and inpatient encounters and scheduled surgeries; reviews encounter forms for accuracy. May be responsible for obtaining pre-certification for scheduled surgeries and admissions.
- May approve Patient Keeper work queue for inpatient encounters.
- May be responsible for collection of time of service payments, and maintaining daily transaction record of collected payments.
- May prepare TOS deposits in Sinai Central.
- Maintains working knowledge and currency in third party payor requirements.
Qualifications
- Associates Degree or high school diploma/GED plus 3 years of relevant experience
- Certified coder required
- Experience in medical billing or health claims, with experience in EPIC & IDX billing systems in a health care or insurance environment preferred
Employer Description
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.
We work hard to acquire and retain the best people and to create an inclusive, welcoming and nurturing work environment where all feel they are valued, belong and are able to professional advance. We share the belief that all employees, regardless of job title or expertise contribute to the patient experience and quality of patient care.
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
Compensation
The Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $20.4566 - $30.685 Hourly. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.
