Revenue Integrity Specialist-Chargemaster-Corporate 42nd Street- Full-Time- Days- Hybrid

Revenue Integrity Specialist-Chargemaster-Corporate 42nd Street- Full-Time- Days- Hybrid

The Revenue Integrity Specialist 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) focuses on optimizing charge capture, reconciliation and process improvement for hospital-based revenue producing departments and the ambulatory sites. By fostering strong, collaborative relationships across the organization, this role will promote financial stewardship and facilitate bidirectional communication with clinical departments, providers, and key stakeholders. The Revenue Integrity Specialist will leverage their expertise in clinical workflows, revenue cycle management, and Epic to proactively identify and execute process improvements that enhance the system's financial health. 

This position reports to the Senior Manager of Revenue Integrity. The position requires the consistent exercise of independent professional judgment in interpreting, applying, and operationalizing complex clinical, regulatory, and reimbursement frameworks impacting revenue integrity.

Charge Capture and Revenue Accuracy

• Ensure accurate charge capture, reconciliation, and compliance for all facility and professional services for designated service line.

• Subject matter authority responsible for interpreting and applying charge methodology for services within designated service line. 

• Monitor charge baselines to identify variances, analyze causes of charge lag, and collaborating with key stakeholders implement workflow improvements to reduce late charges.

• Subject matter authority and expert for the Charge Description Master (CDM/EAP), performing professional-level quality review and validation of additions, deletions, and revisions and ensures compliant charge code structures are available for all services within designated area. 

Compliance and Auditing

• Conducts independent revenue integrity analyses of clinical documentation and billing outputs, requiring interpretation of coding, reimbursement, and payer rules.

• Perform chart to bill audits to ensure accurate charge, price and quantity, mitigating risks and ensuring compliance. 

• Analyze physician and service line charges to ensure compliance with payer regulations, methodologies, and managed care contract.

• Coordinate special focus reviews, collaborating with compliance, patient access, and clinical departments.

• Mitigate the risk of compliance violations, audits, and potential penalties related to charging errors.

• Ensure compliance with all HIPAA privacy and security standards.

Process Optimization

• Independently designs, evaluates, and ensures implementation of revenue integrity workflows and controls, requiring application of professional judgment.

• Develops, refines, and implements efficient processes and controls to optimize revenue integrity. 

• Collaborate with HIM, billing, IT, and clinical stakeholders to align workflows, resolve billing issues, and manage Epic work queues.

• Exercises independent professional judgment to develop and refine the processes necessary to complete the work along with the ability to organize people and activities.

Education & Stakeholder Collaboration

• Provides interpretive guidance to clinical departments on reimbursement policy, coding updates, and charge capture requirements based on professional expertise.

• Educate clinical departments on CPT updates, EAP changes, and new/expanded services.  

• Provides education to designated service lines on quarterly and end of year CPT updates and communicates any EAP updates/changes.

• Establish and maintain strong working relationships with revenue cycle leaders, clinical leaders and staff, other key stakeholders, and foster a strong working relationship with key strategic partners.

• Performs other duties as assigned

• Bachelors degree in public health/administration, finance, business or a related field (clinical degree, RN, PT, OT, RT etc.,) or equivalent education and experience.
• 3-5 years working in a healthcare provider organization clinical department and/or 
  1-2 years working in a healthcare provider organization clinical department with 2 plus years? experience in healthcare revenue cycle, revenue integrity, HIM or finance
• Hospital and/or Professional Charge Experience
• Epic experience preferred
• Experience in one of the following areas Pharmacy, Hematology - Oncology, Laboratory and Pathology, Faculty Practices, Cardiology, Imaging, Rehabilitation or Hospital Based Services. 
• Coding certification, a plus.  
  

Non-Bargaining Unit, 506 - Chargemaster/Projects - MSH, Mount Sinai Hospital

Strength through Unity and Inclusion

The Mount Sinai Health System is committed to fostering an environment where everyone can contribute to excellence. We share a common dedication to delivering outstanding patient care. When you join us, you become part of Mount Sinai’s unparalleled legacy of achievement, education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in creating a culture that ensures fair access to opportunities, promotes inclusive practices, and supports the success of every individual.

At Mount Sinai, our leaders are committed to fostering a workplace where all employees feel valued, respected, and empowered to grow. We strive to create an environment where collaboration, fairness, and continuous learning drive positive change, improving the well-being of our staff, patients, and organization. Our leaders are expected to challenge outdated practices, promote a culture of respect, and work toward meaningful improvements that enhance patient care and workplace experiences. We are dedicated to building a supportive and welcoming environment where everyone has the opportunity to thrive and advance professionally. Explore this opportunity and be part of the next 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 48,000 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 more than 9,000 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, top 5 in Cardiology/Heart Surgery, and top 20 in 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. 11 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.

Equal Opportunity Employer

The Mount Sinai Health System is an equal opportunity employer, complying with all applicable federal civil rights laws. We do not discriminate, exclude, or treat individuals differently based on race, color, national origin, age, religion, disability, sex, sexual orientation, gender, veteran status, or any other characteristic protected by law. We are deeply committed to fostering an environment where all faculty, staff, students, trainees, patients, visitors, and the communities we serve feel respected and supported. Our goal is to create a healthcare and learning institution that actively works to remove barriers, address challenges, and promote fairness in all aspects of our organization.

Compensation

The Mount Sinai Health System (MSHS) provides salary ranges that comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $79720 - $119580 Annually. Actual salaries depend on a variety of factors, including experience, education, and operational need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.