Mount Sinai Medical Center
Overview
Auditing Manager CPC Coders role at Mount Sinai Medical Center. Hybrid work setting; Florida residency required. Since 1949, Mount Sinai Medical Center has been committed to providing access to its diverse community with a focus on clinical excellence, education, and research. We are a large private not-for-profit hospital system serving South Florida with facilities across Miami-Dade and Monroe Counties. Position Summary: The Auditing Manager of Professional Fee Coders is responsible for leading and managing the auditing function for professional fee coding across multiple specialties. This role ensures coding accuracy, compliance with regulatory guidelines, and optimal reimbursement through proactive audit strategies, coder education, and collaboration with clinical and financial teams. Key Responsibilities
Audit Oversight & Execution Develop and implement a comprehensive auditing program for professional fee coding. Conduct routine and targeted audits to assess coding accuracy, documentation quality, and compliance with CMS, CPT, ICD-10, and payer-specific guidelines. Oversee external Specialty audits for the various practices throughout the institution. Analyze audit findings and identify trends, risks, and opportunities for improvement. Team Leadership & Development Supervise a team of professional fee coders and the auditing team, providing mentorship, performance feedback, and ongoing training. Coordinate onboarding and continuing education for coding staff to maintain certifications and stay current with regulatory changes. Compliance & Risk Management Collaborate with Compliance and Legal departments to ensure adherence to federal and state regulations. Support internal and external audit processes, including RAC, MAC, and payer audits. Maintain documentation of audit results and corrective actions for compliance reporting. Reporting & Analytics Prepare detailed audit reports and dashboards for leadership, highlighting key metrics and trends. Monitor coding productivity and quality metrics, recommending process improvements where needed. Stakeholder Collaboration Work closely with physicians, clinical documentation improvement (CDI) teams, and revenue cycle leadership to resolve coding discrepancies and improve documentation practices. Serve as a subject matter expert on coding guidelines and reimbursement policies. Qualifications
Education & Certification Certified Professional Medical Auditor (CPMA) Bachelor’s degree in Health Information Management, Healthcare Administration, or related field (preferred) Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent credential required Experience Minimum 5 years of experience in professional fee coding, with at least 2 years in a leadership or auditing role Strong knowledge of CPT, ICD-10, HCPCS, and E/M coding guidelines Experience with electronic health records (EHRs), coding software, and audit tools Skills Excellent analytical, organizational, and communication skills Ability to lead and motivate teams in a fast-paced environment Proficiency in Microsoft Office Suite and data reporting tools Working Conditions
Hybrid work environment, Florida resident required Benefits
Health benefits Life insurance Long-term disability coverage Healthcare spending accounts Retirement plan Paid time off Pet Insurance Tuition reimbursement Employee assistance program Wellness program On-site housing for select positions and more
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Auditing Manager CPC Coders role at Mount Sinai Medical Center. Hybrid work setting; Florida residency required. Since 1949, Mount Sinai Medical Center has been committed to providing access to its diverse community with a focus on clinical excellence, education, and research. We are a large private not-for-profit hospital system serving South Florida with facilities across Miami-Dade and Monroe Counties. Position Summary: The Auditing Manager of Professional Fee Coders is responsible for leading and managing the auditing function for professional fee coding across multiple specialties. This role ensures coding accuracy, compliance with regulatory guidelines, and optimal reimbursement through proactive audit strategies, coder education, and collaboration with clinical and financial teams. Key Responsibilities
Audit Oversight & Execution Develop and implement a comprehensive auditing program for professional fee coding. Conduct routine and targeted audits to assess coding accuracy, documentation quality, and compliance with CMS, CPT, ICD-10, and payer-specific guidelines. Oversee external Specialty audits for the various practices throughout the institution. Analyze audit findings and identify trends, risks, and opportunities for improvement. Team Leadership & Development Supervise a team of professional fee coders and the auditing team, providing mentorship, performance feedback, and ongoing training. Coordinate onboarding and continuing education for coding staff to maintain certifications and stay current with regulatory changes. Compliance & Risk Management Collaborate with Compliance and Legal departments to ensure adherence to federal and state regulations. Support internal and external audit processes, including RAC, MAC, and payer audits. Maintain documentation of audit results and corrective actions for compliance reporting. Reporting & Analytics Prepare detailed audit reports and dashboards for leadership, highlighting key metrics and trends. Monitor coding productivity and quality metrics, recommending process improvements where needed. Stakeholder Collaboration Work closely with physicians, clinical documentation improvement (CDI) teams, and revenue cycle leadership to resolve coding discrepancies and improve documentation practices. Serve as a subject matter expert on coding guidelines and reimbursement policies. Qualifications
Education & Certification Certified Professional Medical Auditor (CPMA) Bachelor’s degree in Health Information Management, Healthcare Administration, or related field (preferred) Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent credential required Experience Minimum 5 years of experience in professional fee coding, with at least 2 years in a leadership or auditing role Strong knowledge of CPT, ICD-10, HCPCS, and E/M coding guidelines Experience with electronic health records (EHRs), coding software, and audit tools Skills Excellent analytical, organizational, and communication skills Ability to lead and motivate teams in a fast-paced environment Proficiency in Microsoft Office Suite and data reporting tools Working Conditions
Hybrid work environment, Florida resident required Benefits
Health benefits Life insurance Long-term disability coverage Healthcare spending accounts Retirement plan Paid time off Pet Insurance Tuition reimbursement Employee assistance program Wellness program On-site housing for select positions and more
#J-18808-Ljbffr