Revenue Integrity Specialist-(Audits & Denials) Revenue Integrity-Corporate 42nd Street- Full-T[...]

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 ambulatory sites. By fostering strong, collaborative relationships across the organization, this role promotes financial stewardship and facilitates bidirectional communication with clinical departments, providers, and key stakeholders. The specialist leverages expertise in clinical workflows, revenue cycle management, and Epic to proactively identify and execute process improvements that enhance the system's financial health. Qualifications 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+ 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. Responsibilities Charge Capture and Revenue Accuracy Ensure accurate charge capture, reconciliation, and compliance for all facility and professional services within the designated service line. Act as subject-matter authority responsible for interpreting and applying charge methodology for services within the designated line. Monitor charge baselines to identify variances, analyze causes of charge lag, and collaborate with stakeholders to implement workflow improvements that reduce late charges. Serve as the expert for the Charge Description Master (CDM/EAP), performing professional-level quality review and validation of additions, deletions, and revisions and ensuring compliant charge-code structures are available for all services within the area. Compliance and Auditing Conduct independent revenue-integrity analyses of clinical documentation and billing outputs, interpreting 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 contracts. 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 design, evaluate, and ensure implementation of revenue-integrity workflows and controls, applying professional judgment. Develop, refine, and implement 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. Exercise independent professional judgment to develop and refine the processes necessary to complete the work and organize people and activities. Education & Stakeholder Collaboration Provide interpretive guidance to clinical departments on reimbursement policy, coding updates, and charge capture requirements based on expertise. Educate clinical departments on CPT updates, EAP changes, and new or expanded services. Provide education to designated service lines on quarterly and year-end CPT updates and communicate any EAP updates or changes. Establish and maintain strong working relationships with revenue-cycle leaders, clinical leaders and staff, other key stakeholders, and foster strong partnerships. Perform other duties as assigned. Compensation The Mount Sinai Health System (MSHS) provides a salary range of $79,720.00 – $119,580.00 annually. Actual salaries depend on a variety of factors, including experience, education, and operational need. The range listed does not include bonuses, incentives, differential pay, or other forms of compensation or benefits. 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 or exclude individuals based on race, color, national origin, age, religion, disability, sex, sexual orientation, gender, veteran status, or any other characteristic protected by law. We are committed to fostering an inclusive environment where all faculty, staff, students, trainees, patients, visitors, and the communities we serve feel respected and supported. #J-18808-Ljbffr Mount Sinai Health System