Senior Coding Auditor (JR229354)

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Tarrytown, New York

Montefiore

<h4 class=""><strong>WHY TOP TALENT PICKS MONTEFIORE EINSTEIN&nbsp;<br /><br /></strong>Since its inception in 1884, Montefiore Einstein&rsquo;s mission has been to heal, to teach, to discover and advance the health of the communities we serve.<br /><br />Montefiore Einstein&rsquo;s state-of-the-art facilities include the&nbsp;<span class="">internationally-recognized</span>&nbsp;Children&rsquo;s Hospital at Montefiore Einstein 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 throughout the Bronx and Westchester County, Montefiore Einstein is the ideal organization to apply and hone your expertise.<br /><br /><span style="text-decoration: underline;"><a href="https://montefiore.wd12.myworkdayjobs.com/en-US/MMC/login" target="_blank" title="Candidate Home" rel="noopener noreferrer">Sign In</a></span>&nbsp;- Candidate Home<br /><span style="text-decoration: underline;"><a href="https://montefiore.wd12.myworkdayjobs.com/en-US/MMC/introduceYourself" target="_blank" title="Introduce Yourself " rel="noopener noreferrer">Introduce Yourself&nbsp;</a></span>-&nbsp;Please let us know about yourself so we can keep in touch about future job openings!<br /><br /><strong><span class="">NURSE&nbsp;RECRUITMENT&nbsp;HOTLINE:</span>&nbsp;<span class="">718-920-6697 (</span><span class="">Monday-Friday: 9am-4pm)&nbsp;&nbsp;</span></strong><br /><br /><strong>Check Out Our Employee&nbsp;<span style="text-decoration: underline;"><a href="https://healthymebenefits.com/" target="_blank" title="Benefits" rel="noopener noreferrer">Benefits</a></span></strong></h4> <h4 class="p1"><span style="text-decoration: underline;"><strong><a href="https://s3.us-east-1.amazonaws.com/vizi.vizirecruiter.com/MontefioreHealthSystem+RecruitingPractices.pdf" target="_blank" title="Safe Online Recruiting" rel="noopener noreferrer">Our Commitment to Safe Online Recruiting</a></strong></span></h4> https://www.montefiore.org/

keywords: position summary,software development,process,education & experience,knowledge,analysis,certification

Full time

$76,632.04-$95,790.05

Overview: <strong>Job Summary</strong><br /><br />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.&nbsp;
Responsibilities: <ul> <li>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.</li> <li>Works cooperatively with the Associate Directors/Director in the identification of process improvement initiatives related to the coding and charging of hospital services. &nbsp;</li> <li>The Senior Coding Auditor provides guidance and support to the Coding Auditors as requested or required. &nbsp;</li> <li>The Senior Coding Auditor also assists with quality assurance reviews, data analysis, workload monitoring and distribution, and training.</li> <li>&nbsp;75% of time allocated towards Chart/Coding Review, 25% for other duties.</li> </ul>
Requirements: <ul> <li>Bachelor&rsquo;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.</li> <li>Work experience with PCs, word processing, spreadsheets, graphs, and database software applications.</li> <li>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.</li> <li>Strong quantitative, analytical, and communication skills required.&nbsp;</li> <li>Understand medical record, hospital bills, insurance terms, payment methodologies and the charge master.</li> <li>Knowledge of regulatory agencies requirements (JCAHO, CMS &amp; Medicaid) and remain current on new regulations, policies and procedures.</li> <li>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.&nbsp;</li> <li>Knowledge of hospital clinical and financial IT applications is required.</li> <li>Understanding of the charge capture and the charge creation process is required.</li> <li>Understanding of the bill compilation and presentation process is required.</li> <li>Understanding of UB-04, itemized statement and medical records in addition to the familiarity with all ancillary department functions for the facility.&nbsp;</li> <li>Previous clinical experience in an acute care facility is preferred.</li> <li>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).</li> </ul>