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Job Description

Director of Enterprise Charge Description Master (CDM) -Patient Financial Services-Corporate 42nd Street-Full-Time -Days- Hybrid

The Director of the Enterprise Chargemaster (CDM) 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) is a leadership role responsible for implementing the overall strategic direction and operational oversight for the professional charge description master, the Enterprise CDM optimization, and provide facility strategic pricing.

This position plays a key role in ensuring the financial health and compliance of the organization and integrates the facility and professional chargemaster process for a seamless workflow and provides facility strategic pricing. This position will report to the Senior Director, Finance of the MSHS.

Qualifications

+ Bachelor's degree in public health/administration or business or a related field or equivalent education, experience and certification.

+ Ten (10) plus years’ experience in a health system setting responsible for the Charge Description Master, preferably in an academic medical center.

+ 5 plus years with Epic Experience

+ Demonstrated success in a large not-for-profit/academic health system facility or multi-entity revenue cycle environment.

+ Proficiencies: Extensive knowledge of revenue cycle processes and hospital/ medical billing to include CDM, UB, RAs and 1500. Extensive knowledge of code data sets to include CPT, HCPCS, and ICD 10. Extensive knowledge of NCCI edits, and Medicare LCD/NCDs. Extensive understanding of reimbursement theories to include DRG, OPPS, HCC and managed care. Extensive working knowledge of health care compliance.

+ Capacity to review, analyze and interpret managed care contracts, billing guidelines, and state and federal regulations along with facilitating to all member entities. Ability to work with and interpret detailed medical record documents and communicate effectively with physicians, nursing staff, leadership and other billing personnel.

+ Excellent interpersonal skills and experience working with senior management and other leaders, along with the ability to communicate concepts to others.

+ Demonstrated ability to engage in positive, powerful persuasion with individuals or groups with diverse opinions and/ or agendas, leading to outcomes that meet identified goals.

+ Excellent verbal and written communication and organizational abilities. Accuracy, attentiveness to detail and time management skills are required.

+ Ability to prioritize multiple objectives in a rapidly changing environment and deliver quality outcomes.

Certification:

Applicable professional certification through AHIMA (RHIA, RHIT, CCS, CCS-P) or AAPC (CPC, COC), preferred

Compensation Statement

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 $169,005.00 - $253,643.00 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.

Non-Bargaining Unit, 518 - PFS 633 Third Avenue - MSH, Mount Sinai Hospital

Responsibilities

+ Responsible for management and adherence to all Federal, State and Regulatory requirements and guidelines for the Professional Charge Description Master.

+ Responsible for developing and maintaining the Professional Charge Description Master and integrating the Facility and Professional Charge Description Master (CDM) as appropriate.

+ Collaborate with financial, clinical, technical, and operational stakeholders to facilitate the planning, execution, and successful transition of data from legacy Charge Description Master to the Epic platform.

+ Develops strategic pricing initiatives, collaborating with key stakeholders to ensure alignment with business objectives and market conditions.

+ Works with providers and clinical areas to ensure the MSHS Enterprise CDM accurately reflects the services provided.

+ Develops policies and procedures for maintaining the MSHS Enterprise CDM.

+ Responsible for oversight of all new charge code requests, ensuring correct Enterprise Charge Description Master build, mapping and communication to appropriate teams.

+ Responsible for implementing routine, standardized reporting to provide stakeholders with commonly requested MSHS Enterprise CDM extracts, revenue and usage and other reporting.

+ Serves as an Enterprise Charge Description Master resource for executives and leadership, and provides support to the MSHS Enterprise CDM team, revenue cycle and hospital stakeholders.

+ Responsible for a detailed, annual review of the Enterprise CDM to ensure compliance with all Federal and State regulations and accurately reflects charges for all services provided.

+ Assesses and identifies services that are reimbursable but are not being coded; reviews, assigns, and validates revenue codes to insure proper billing in collaboration with other revenue cycle teams.

+ Works in conjunction with stakeholders to ensure that any third-party systems have appropriate charge codes and two – way extracts, as appropriate.

+ Communicates and reviews impact on operations of third-party requirements for charging, coding or billing changes with defined stakeholders.

+ Develops and or maintains reports to identify various metrics as defined by leadership or needed for departmental monitoring.

+ Serve as the subject matter expert based on experience and certification for clinical departments, finance, and information technology.Collaborate with multi-disciplinary teams to manage and reduce candidate for billing (CFB).

+ Engage with IT teams and vendors to implement system upgrades, enhancements, and automation solutions.

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

+ Resourceful in creating or fine-tuning the processes necessary to complete the work along with the ability to organize people and activities.

+ Challenge existing norms or courses of action to facilitate fully informed decision-making.

+ Help institute balanced decision-making by identifying risks and opportunities.

+ Establish and maintain strong working relationships with revenue cycle leaders, key stakeholders, and foster a strong working relationship with key strategic partners.

+ Create feedback loops and enhancement pipelines informed by stakeholders and data.

+ Ensure compliance with all HIPAA privacy and security standards.

+ Conform to the established policies/ procedures/ processes/ Standards of Behavior.

+ Performs other duties as assigned

About Us

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 Statement

Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $169005 - $253643 Annually. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.