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MEDICAL AUDIT ANALYST

BRONX, NY, US


  • CPC certification is required for interested candidates. Candidate must have knowledge of the principles and procedures of coding. 
  • Candidate will be responsible for the following:
    • Coding review/correction for patient encounters and surgery cases (e.g., bundling, LCD edits).  Ensure proper coding, timely documentation and billing by physicians and APPs.
    • Review medical records to ensure data is complete and supports procedures reported. Determine and apply  appropriate billing mechanisms (LOA).
    • Review and resolve coding related edits captured in the department WQs.
    • Analyze coding related denials; liaise/work with AR team in Professional Services to reduce coding denials, appeal claim denials, providing letter of medical necessity and any required documentation.
    • Participate in various programs that affect coding, clinical data and billing optimization.
    • Assist in research and other analytical projects such as evaluate billing and coding practices within the department.  Assist providers in documentation issues and in providing data.
    • Initiates and conducts analysis of coding trends to identify missing, incomplete, or questionable data.
    • Maintain coding skills and knowledge of changing regulations.
  • Candidate must have:
    • Strong organizational, analytical and writing skills.
    • Excellent verbal and communication skills.
    • Ability to educate staff and the physicians.
    • Liaise with other departments such as Professional Services, Other practices (i.e., co-surgeries).
    • Maintain good working relationships within and outside of the department.

 

Department: Neurosurgery Bargaining Unit: Non Union Campus: MOSES  Employment Status: Regular Full-Time Address: 3316 Rochambeau Ave, Bronx
Shift: Day Scheduled Hours: 8:30 AM-5 PM Req ID: 102979 

 

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. 

 

N/A 


Mission:
To heal, to teach, to discover and to advance the health of the communities we serve.

Vision:
To be a premier academic medical center that transforms health and enriches lives.

Values
Define our philosophy of care, they shape our actions and motivate and inspire us to pursue excellence and achieve the goals we have set forth for the future. Our values include:

  • Humanity
  • Innovation
  • Teamwork
  • Diversity
  • Equity

 

 

 

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