Job Description

Reporting to the Faculty Practice Administrator, the Revenue Cycle Manager is responsible for converting operational data into comprehensive and concise user reports in support of Revenue Cycle operations for the Icahn Mount Sinai School of Medicine’s Elmhurst and Queens, Faculty Practice Groups, ensuring transparent translation of the stakeholders’ requirements into reporting deliverables. Responsibilities include but are not limited to, establishing and maintaining procedures to maximize charge capture, billing, accounts receivable follow up, resolution of edits and claim denials all within the constraints of payor timely filling guidelines. Serves as liaison between external business relationships to maintain the Faculty Practice Groups (FPG) revenue cycle business needs and mission.

Qualifications

Bachelor's Degree, Master's preferred

Comprehensive knowledge of Government and Third-Party Payors

5 years Revenue Cycle Supervisory experience

Certified Professional Coder (CPC) or any other Professional Billing Certifications, preferred

EPIC PB Revenue Cycle, ERM and Reporting

Strong Excel skills

Microsoft Business

Excellent written and oral communication skills

Exceptional attention to detail and accuracy

Responsibilities

Coordinates the development of ad hoc user reports to target charge capture, denials and critical issues focusing on resolution. Proactively build and develop problem audit reports for revenue enhancement.

Create and review reports for all medical specialty departments then perform a deep dive analysis to reduce controllable rejections by applies knowledge of coding, including use of billable CPTs, diagnosis codes, modifiers, place of service codes and other claim codes to identify root cause for denial specific to each modality.

Meet with Directors of Service and their physicians, along with the billing vendor, to discuss all key performance indicators for their department.

Helps to identify data elements required to produce meaningful reports. Extracts, collates, and refines data from one or more sources including Epic Workbench reports, Epic Cubes reporting, Epic Slicer Dicer and SAP Business Objects

Generate and reconcile reports from Epic to ensure all charges are captured. Work with managers and coding staff to ensure to prioritizing daily workflow to ensure the timely submission of claims. Follow up with and billing vendor to identify the outliers and make sure they are processed for billing.

Work with the management team and various payors on special claims projects, by creating reports for submission based on the payors required templets.

Work closely with the billing vendor to create and analyze comparative reports in all areas of the revenue cycle to help improve processes and maximize collections. Identify areas for improvement in Accounts Receivable management. Review any claim rejections and/or denials to ensure timely payment of claims.

Work with the FPG staff and billing vendor to quickly identify and correct any edits generated from the billing platform, coding staff, clearinghouse or Accounts Receivable team.

Work with H+H staff to manage and verify that all required pre-authorizations and approvals are obtained. Assist patients with any professional billing issues and resolve complaints as necessary.

Manage the daily operations of the Faculty Practice 1A. Ensure that the practice runs smoothly, paying particular attention to patient satisfaction and maximization of revenue.

Keeps abreast of state and federal regulations governing reimbursement of all physician services. Maintains the privacy and confidentiality of patient information.

About Us

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.

At Mount Sinai, our leaders strive to learn, empower others, and embrace change to further advance equity and improve the well-being of staff, patients, and the organization. We expect our leaders to embrace anti-racism, create a collaborative and respectful environment, and constructively disrupt the status quo to improve the system and enhance care for our patients. We work hard to create an inclusive, welcoming and nurturing work environment where all feel they are valued, belong and are able to advance professionally.

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 Statement

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 $78884 - $130447.23 Annually. 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.