Director of Coding Integrity and Coding Edits - HSO Health Information Management - Mount Sinai Hospital - Full-Time

Director of Coding Integrity and Coding Edits

• HSO Health Information Management
• Mount Sinai Hospital
• Full-Time Mount Sinai Health Systems
• 3.7 New York, NY Job Details Full-time $139,748
• $209,622 a year 1 hour ago Qualifications Quality control corrective actions Performance monitoring Strategic management Program management Inpatient RHIA Team leadership Program development Healthcare Administration CMS Coding for outpatient services RHIT 8 years System maintenance Health information performance improvement Key Performance Indicators CMS regulatory compliance Bachelor's degree Charge capture (medical billing) Medicare regulations Medical denial trend identification System validation Certified Coding Specialist Quality compliance management Health information regulatory compliance Centers for Medicare & Medicaid Services (CMS) billing regulations Bachelor's degree in healthcare administration Management reporting Health information management Operational excellence initiatives Full Job Description Description The Director of Coding Integrity and Coding Edits provides strategic leadership and operational oversight for coding integrity programs, coding edit governance, and coding quality initiatives across the organization.

This role ensures accurate, compliant, and optimized coding practices to support appropriate reimbursement, regulatory compliance, and overall revenue cycle performance. The Director partners closely with the Director of Revenue Integrity and the Director of Hospital Billing (HB) Coding to align coding practices with charge capture, claim edits, payer requirements, and revenue cycle optimization. The position works collaboratively across HIM, revenue cycle, compliance, and clinical teams to ensure coding integrity and operational efficiency. Responsibilities Coding Integrity Strategy Develop and lead the organization's coding integrity program to promote accurate and compliant clinical coding. Establish policies, procedures, and governance related to coding integrity and coding edits. Ensure adherence to coding guidelines including: o

ICD-10-CM

o

ICD-10-PCS

o CPT o HCPCS ________________________________________ Coding Edit Management Oversee development, maintenance, and optimization of coding-related system edits. Manage edit governance for coding validation, claim edits, and coding quality rules. Work with IT and revenue cycle teams to ensure proper configuration of coding edits in billing and coding systems. Evaluate edit performance to reduce claim rework and improve first-pass claim acceptance. ________________________________________ Cross-Functional Revenue Cycle Collaboration Partner closely with: Director of Revenue Integrity Align coding practices with charge capture and charge master governance. Ensure coding accuracy supports appropriate reimbursement. Identify revenue leakage or missed revenue opportunities related to coding. Director of Hospital Billing Coding Standardize inpatient and outpatient coding practices. Improve coding quality and consistency across coding teams. Address coding-related claim edits and billing issues. ________________________________________ Coding Quality and Compliance Develop and oversee coding audit and monitoring programs. Identify trends and implement corrective action plans to improve coding accuracy. Ensure compliance with regulatory and industry guidance from organizations including: o Centers for Medicare & Medicaid Services o American Hospital Association o American Medical Association Support internal and external audits related to coding compliance. ________________________________________ Coding Education and Continuous Improvement Collaborate with coding education teams to ensure coders remain current with coding guideline changes. Identify areas requiring targeted education or process improvement. Support implementation of annual coding updates and regulatory changes. ________________________________________ Data Analytics and Reporting Monitor key performance indicators related to coding accuracy, edit performance, and denial trends. Utilize analytics to identify coding opportunities, trends, and operational improvements. Provide reporting and recommendations to the Senior Director of Coding and revenue cycle leadership. Qualifications Bachelor's degree in Health Information Management, Healthcare Administration, or related field preferred 8-10+ years of experience in hospital coding, coding compliance, or revenue cycle operations. 5+ years in leadership or management roles. Experience managing coding integrity initiatives, coding edits, and coding compliance programs. Strong experience collaborating with revenue cycle, compliance, and HIM leadership. Active professional coding credential(s) Active professional coding credential(s) (e.g., RHIA, RHIT, CCS, CCS-P). Employer Description 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 $139748

• $209622 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.