Senior Coding Auditor

3000 Montefiore Medical Center; South Broadway (WA); On-site; USD 77,000 - 96,000; Full time

Job summary

Montefiore Medical Center in Tarrytown, NY is seeking a Senior Coding Auditor to perform detailed audits of medical cases, ensuring accuracy of codes, charges, and documentation and to support the revenue integrity engagement team. The role involves reviewing current and retro accounts, reporting audit outcomes, and collaborating with leadership to identify process improvements.

A 75% focus on chart and coding review and 25% on other duties.

Qualifications

• Minimum 2 years of related auditing or coding experience.
• Knowledge of CPT/HCPCS coding and reimbursement practices.
• Proficient with hospital information systems and data analysis.

Responsibilities

• Perform detailed audits of medical cases to verify codes and charges.
• Review documentation and ensure compliance with coding guidelines.
• Report audit outcomes and support process-improvement initiatives.
• Mentor junior auditors as assigned.

Skills

Analytical skills

Communication skills

Quality auditing

Education

Bachelor’s degree in Nursing or related field

Tools

Microsoft Word

Microsoft Excel

Databases

Billing software

Job description

City/State: Tarrytown, New York

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

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.

Qualifications: Bachelor’s degree (or equivalent) in Nursing, health-related field , Accounting, Finance , Management or related field and a minimum of 2 years of related experience, or an equivalent combination of education and work experience. Required 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).

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.

Calling All Nurses! Nurse Recruitment Hotline: [phone]; Monday-Friday: 9am-4pm

Since its inception in 1884, Montefiore’s mission has been to heal, to teach, to discover and advance the health of the communities we serve. Montefiore's state-of-the-art facilities include the internationally-recognized Children’s Hospital at Montefiore and our Notable Centers of Excellence - Montefiore Einstein Center for Cancer Care, Montefiore Einstein Center for Heart and Vascular Care, Montefiore Einstein Center for Transplantation. Combined with a growing number of locations for primary and specialty care throughout the Bronx and Westchester County, Montefiore is the ideal organization to apply and hone your expertise.

An assortment of insurance products and discount programs through Voluntary Benefits.

Check out our comprehensive benefits available to you when you join our outstanding team! To heal, to teach, to discover and to advance the health of the communities we serve. To be a premier academic medical center that transforms health and enriches lives.

Automated Employment Decision Tools Notice (AEDT)