SENIOR MEDICAL AUDIT ANALYST

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Job description

The impact of the coding function on the reimbursement and cash flow of the medical center is considerable. Submission of quality data as required by State and National regulatory and accrediting bodies has major impact on MMC reputation and prominence in the health care industry. The Sr. Medical Audit Analyst IP is responsible for the accuracy, consistency and quality of coding using recognized disease and procedure coding classifications (ICD-10, ICD-O, CPT- 4 HCPCS etc.) Evaluate correct sequencing of codes to ensure appropriate billing and reimbursement. Evaluate reason for SMART edits. Correct and update as required. Understand the role of coding based on Chart Review versus Charge Master assignment. Conduct performance improvement activities regarding coding accuracy, completeness, data quality and integrity; identify issues in correct sequencing of codes and assignment of grouper payment methodology,Collaborate with physician, nursing and other clinical staff and review agencies on responses to denials, and other issues and to obtain clarification on documentation of clinical care. Provide guidance and coaching to staff as required.

EDUCATION/SKILLS/KNOWLEDGE:

High School Diploma/GED required.

Candidates for this position must have satisfactorily completed a course in Coding using ICD -10CM, ICD-10 PCS and CPT4 and other applicable disease and procedure coding classifications AND must have experience coding, reviewing and abstracting records for patients in all levels of care in a complex health care environment such as Montefiore.

Three(3) to five(5) years related experience. Experience in HIM preferred.

Candidates must demonstrate knowledge of coding techniques and be familiar with reviewing medical records in an electronic environment. Critical thinking and excellent communication skills

Certification required RHIA RHIT CCS /CCS-P /CPC

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For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.

To learn more about the "Montefiore Difference" - who we are at Montefiore and all that we have to offer our associates, please click .

Diversity, equity and inclusion are core values of Montefiore. We are committed to recruiting and creating an environment in which associates feel empowered to thrive and be their authentic selves through our inclusive culture. We welcome your interest and invite you to join us.

Montefiore is an equal employment opportunity employer. Montefiore 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.

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