Senior Coding Auditor

Montefiore Health System; New York (NY); On-site; USD 76,632 - 95,790; Full time

Job summary

Montefiore Health System seeks a Senior Coding Auditor in Tarrytown, New York. The role involves auditing medical cases for coding accuracy and ensuring compliance with regulations. Candidates need a Bachelor’s degree in a relevant field and at least 2 years of experience. Proficiency in hospital systems, coding methodologies, and strong analytical skills are essential. The position operates on a weekday schedule, 8:30 AM to 5 PM, offering a salary range of $76,632.04 to $95,790.05.

Qualifications

• Bachelor's degree in Nursing, health-related field, Accounting, Finance, Management or related field.
• Minimum of 2 years of related experience or equivalent combination of education and work experience.
• Proficient in payment review systems, hospital information systems, and clinical record information systems.

Responsibilities

• Perform detailed audits of medical cases to ensure accuracy of assigned codes.
• Assist with quality assurance reviews, data analysis, and workload monitoring.
• Work on charge errors and report outcomes regarding charge savings or losses.

Skills

Quantitative skills

Analytical skills

Communication skills

Proficient in coding methodologies

Knowledge of regulatory agencies requirements

Education

Bachelor’s degree in Nursing or relevant field

Tools

Hospital information systems

Payment review systems

Database software applications

Job description

Job Summary

The Senior Coding Auditor performs detailed audits of medical cases to ensure accuracy of assigned codes, charges, availability of documented medical records, medical accounts, and compares the cases with the itemized bill and overall procedures. The Senior Coding Auditor reviews and audits current and retro accounts, and reports audit outcomes regarding charge errors, percentage of savings or losses for the facility, data processing errors, the performance of the hospital charging system as well as documentation and justification within the medical record and itemized bill. Works cooperatively with the Associate Directors/Director in the identification of process improvement initiatives related to the coding and charging of hospital services. The Senior Coding Auditor provides guidance and support to the Coding Auditors as requested or required. The Senior Coding Auditor also assists with quality assurance reviews, data analysis, workload monitoring and distribution, and training. 75% of time allocated towards Chart/Coding Review, 25% for other duties.

Location

Tarrytown, New York

Employment Details

Grant Funded: No

Department: REV - Revenue Integrity Engagement Team

Work Shift: Day

Work Days: MON-FRI

Scheduled Hours: 8:30 AM-5 PM

Scheduled Daily Hours: 7.5 HOURS

Pay Range: $76,632.04-$95,790.05

Qualifications

• Bachelor’s degree (or equivalent) in Nursing, health-related field, Accounting, Finance, Management or related field
• Minimum of 2 years of related experience, or an equivalent combination of education and work experience.
• Work experience with PCs, word processing, spreadsheets, graphs, and database software applications.
• Proficient in payment review systems, hospital information systems, clinical record information systems, insurance terms and payment and some coding methodologies. Knowledge of revenue codes CPT/HCPCS, billing and coding edits (i.e., CCI, OCE, MUE, LCD/NCD) and billing and reimbursement practices.
• Strong quantitative, analytical, and communication skills required.
• Understand medical record, hospital bills, insurance terms, payment methodologies and the charge master.
• Knowledge of regulatory agencies requirements (JCAHO, CMS & Medicaid) and remain current on new regulations, policies and procedures.
• Knowledge of coding guidelines, both ICD-10-CM and CPT-4 and understands CMS (formerly HCFA) Memos and Transmittals and all ancillary department functions for the facility.
• Knowledge of hospital clinical and financial IT applications is required.
• Understanding of the charge capture and the charge creation process is required.
• Understanding of the bill compilation and presentation process is required.
• Understanding of UB-04, itemized statement and medical records in addition to the familiarity with all ancillary department functions for the facility.
• Previous clinical experience in an acute care facility is preferred.
• Certifications/Registrations preferred: American Health Information Association (AHIMA); Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Coding Specialist (CCS); or Certified Procedural Coder, Hospital (CPC-H).

EEO Statement

Montefiore Medical Center is an equal employment opportunity employer. Montefiore Medical Center will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.