FPA Professional Fee Coding Specialist-FPA CBO

Strength Through Diversity

Ground breaking science. Advancing medicine. Healing made personal.

The FPA Professional Fee Coding Specialist reviews clinical documentation and diagnostic results to extract data and apply appropriate ICD-10 CM and CPT – 4 codes for billing, internal and external reporting, research and regulatory compliance. This individual accurately codes outpatient (i.e., diagnostic, therapeutic, ambulatory surgery, emergency room, express care and observation service encounters), conditions and procedures as documented in ICD-10-CM Official Guidelines for Coding and Reporting and AMA CPT Guidelines. Provides information and direction relevant to coding to physicians. A participant in coding document review and staff training; reports to the Director of Coding and the Vice President of FPA CBO.

Roles & Responsibilities:

• Upon review of patient medical records, assigns ICD-10 and CPT (Current Procedural Terminology) codes for diagnoses, treatments, surgical and non-surgical procedures for professional ambulatory services rendered. Assesses support documentation.
• Provides written reports to supervisor or manager with audit results. Documents any coding deficiencies noted.
• Reviews, modifies and recommends changes to policies, procedures, EPIC templates and encounter forms to improve professional fee coding and data management.
• Serves on committees and work groups as appropriate, including the internal coding groups at CBO.
• Implements and manages the coding process for all coding specialties including surgical, medical procedures and E/M professional services.
• Maintains a working knowledge of CPT-4 and ICD-10-CM professional coding principles, government regulations, protocols and third –party requirements pertaining to billing and documentation.
• Assists in the development and implementation of quality assurance programs to monitor staff competency and establish new methodologies to enhance the performance of various departments assigned.
• Other duties as assigned.

Requirements:

• Education: Associates degree (higher level of education is preferred), or equivalent combination of education and relevant coding work experience.
• Experience: 3 years minimum of outpatient professional coding experience, Emergency Room knowledge is desirable.
• Proficiency in the use of computer-assisted coding software.
• Demonstrates the ability to create and utilize the coding audit tools required to include the facilitation of coding deficiency resolution with physicians, managers and staff.

Strength Through Diversity

The Mount Sinai Health System believes that diversity, equity and inclusion are drivers for excellence. We share a common devotion to delivering exceptional patient care. Yet we’re as diverse as the city we call home- culturally, ethically, in outlook and lifestyle. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education, and advancement as we revolutionize medicine together and participate actively as a leader within the Mount Sinai Health System by:

• Serving as the primary resource management representative of the Mount Sinai leadership teams, committees, etc., and acting as the primary executive leader interface between Mount Sinai and key executives from the health systems’ vendors and partners.

• Engaging with relevant thought leaders and policy-makers at the federal and state levels, and representing the Health System as assigned.

• Using a lens of equity in establishing and promoting policies and procedures and providing opportunities for all to thrive.

• Confronting racist, sexist or other inappropriate behavior and challenges exclusionary organizational practices and serving as a role model to promote anti-racist behaviors.

• 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 a welcoming, nurturing work environment where you can develop professionally. We share the belief that all employees, regardless of job title or expertise, can make an impact on quality patient care.

Explore more about this opportunity and how you can help us write a new chapter in our story!

Who We Are

Over 42,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.

Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospital campuses, including Mount Sinai Beth Israel, Mount Sinai Beth Israel Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai Morningside (formerly Mount Sinai St. Luke’s), and New York Eye and Ear Infirmary of Mount Sinai.

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.

EOE Minorities/Women/Disabled/Veterans