Mount Sinai Medical Center
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Coding Compliance Manager
at Mount Sinai Medical Center
US - Florida - Miami Beach
Coding Compliance Manager
As Mount Sinai continues to grow. so does our legacy of caring.
Mount Sinai Medical Center is proud to be South Florida's hospital of choice for great medicine. With more than 4000 employees. 500 volunteers. 670 beds. 26 operating suites and more than 650 physicians and 950 nurses. Mount Sinai is South Florida's largest private independent not-for-profit teaching hospital.
It takes the contribution of many individuals to make Mount Sinai the world-class institution it is today. As a team we have focused our efforts on assuring that our patients receive high quality medical care. We're looking for motivated professionals who seek the challenge and stimulation of working in an academic medical center with an international reputation.
- An excellent team focused work environment with opportunity for professional growth
- Competitive salary with bonus potential
- Savings plan with company match
- A variety of health dental and vision plans
- On-site childcare tuition reimbursement. and much more!
Monitors coding for accuracy and compliance with approved Official Coding Guidelines and AHA Coding Clinic guidance.
Responsible for the day to day management of the audit and education team members which includes implementing and maintaining staff productivity and quality standards.
Performs quality audit assessments for DRG validation, coding accuracy and compliance with approved Official Guidelines for Coding and Reporting, AHA Coding Clinics, and other recognized resources including regulatory agencies and in accordance with MSMC coding policies.
Analyzes and tracks audit results on a monthly basis; produces audit results reports and submits to Directors of HIM and Revenue Integrity and Chief Financial Officer and quarterly to the Ethics and Compliance Committee.
Reports and tracks DRG accuracy rates for coders, trending results and reporting on a monthly basis to the Directors of HIM and Revenue Integrity and quarterly to the Ethics and Compliance Committee.
Conducts education in-services with coding and CDI staff at least quarterly and more frequently when audit results indicate necessity. Utilizes relevant publications, such as Official Guidelines for Coding and Reporting, AHA Coding Clinics, etc. for education. .
Schedules and coordinates external coding audits; providing account sample for audits and scheduling coder education sessions.
Reviews and responds to insurance denials due to coding/MS-DRG changes.
Serves as SME for various hospital committees/departments to ensure hospital goals and objectives are achieved that rely on coded data including but not limited to: Readmission Reduction, Performance Improvement, and Risk Management.
Works closely with CDI team to identify any areas in coding that require documentation improvement and/or coding accuracy.
Partners with Health Information Management (HIM) coding management in developing strategy and programs to address non-compliant or high-risk coding practices.
Identifies trends, patterns and variances in coding and documentation and provides education where necessary.
Researches, summarizes and disseminates information regarding new coding requirements (e.g. annual CPT code updates, etc.) and update appropriate management, providers and coding staff of changes.
Associate or Bachelor’s Degree in Healthcare Business Administration, Finance, or Health Related field or the equivalent combination of training and experience required
7-10 years hospital coding experience with 2 years management experience
Required Licenses/Certifications: AHIMA (CCS)
Additional Preferred Licenses/ Certifications: AAPC Coding Certification (CPC) orRHIT/RHIA.
Preferred Experience: Epic, Smart, 3M 360.