Lead Medical Coding Auditor — Revenue Integrity & QA

Montefiore Health System; Village of Tarrytown (NY); Sur place; USD 85 000 - 115 000; Plein temps

Résumé du poste

Montefiore Medical Center in New York is seeking a Senior Coding Auditor to perform detailed audits of medical cases, ensuring accuracy of codes, charges, and documentation. You will review current and retro accounts, report outcomes, and help identify process improvements in coding and charging hospital services.

You will guide and support junior auditors, participate in quality assurance, data analysis, workload monitoring and training. 75% chart/coding review; 25% other duties.

Qualifications

• Bachelor’s degree or equivalent in a health-related field, accounting, finance, management or related field with at least 2 years of related experience.
• Proficient with PCs, word processing, spreadsheets, graphs and database software.
• Knowledge of revenue codes CPT/HCPCS, billing and coding edits (CCI, OCE, MUE, LCD/NCD) and billing and reimbursement practices.
• Strong quantitative, analytical and communication skills.
• Understanding of medical records, hospital bills, insurance terms and payment methodologies.
• Familiarity with regulatory requirements (JCAHO, CMS & Medicaid) and current regulations.
• Knowledge of ICD-10-CM, CPT-4 and CMS memos/transmittals; familiarity with UB-04 and itemized statements.
• Clinical experience in an acute care facility preferred.
• Certifications: AHIMA RHIT/RHIA, CCS or CPC-H.

Responsabilités

• Audits medical cases to ensure codes and charges are accurate and documented properly.
• Review current and retro accounts and report audit outcomes, detailing savings or losses and data processing errors.
• Identify process improvements related to coding and charging hospital services; provide guidance to Coding Auditors; assist with quality assurance, data analysis, workload monitoring and training.

Connaissances

Quantitative skills

Analytical skills

Communication skills

Formation

Bachelor’s degree in Nursing, health-related field, Accounting, Finance, Management or related field

Outils

Word processing

Spreadsheets

Database software

Description du poste

Montefiore Medical Center in New York is seeking a Senior Coding Auditor to perform detailed audits of medical cases, ensuring accuracy of codes, charges, and documentation. You will review current and retro accounts, report outcomes, and help identify process improvements in coding and charging hospital services.

You will guide and support junior auditors, participate in quality assurance, data analysis, workload monitoring and training. 75% chart/coding review; 25% other duties.