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CLINICAL AUDITOR

TARRYTOWN, NY, US


The Clinical Charge Auditor performs detailed audits of inpatient or outpatient medical accounts, comparing the medical record documentation with the itemized bill, nursing procedures, and department documented charging practices. The auditor coordinates 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.

 

Minimum Requirements:

1. Bachelor’s degree (or equivalent) in Nursing, health-related field, related field and a minimum of 2 years of related experience, or an equivalent combination of education and work experience.
2. Experience with PCs, word processing, spreadsheet, graphics, and database software applications are desired. Previous auditing experience preferred.
3. Strong quantitative, analytical Interpersonal and communication skills. 
4. Proficient in payment review systems, hospital information systems, clinical record information systems, and some coding methodologies. 
5. Ability to understand and interpret medical records, hospital bills, and the charge master along with the ability to understand all ancillary department functions.
6. Ability to understand insurance terms (i.e. HMO/PPO, EOB, stop loss, etc.) and payment methodologies and to effectively negotiate with insurance carrier representatives and customers.
7. Knowledge of regulatory agencies requirements (JCAHO, CMS & Medicaid) and remain current on new regulations, policies and procedures.

 

Department: Revenue Cycle Bargaining Unit: Non Union Campus: TARRYTOWN  Employment Status: Regular Full-Time Address: 555 South Broadway, Tarrytown
Shift: Day Scheduled Hours: 8:30 AM-5 PM Req ID: 103285 

 

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. 

 

#GDMD; 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

 

 

 


Nearest Major Market: White Plains
Nearest Secondary Market: New York City