CLINICAL AUDITOR

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.

Education/Skills:

Minimum Requirements:

1. Bachelor’s degree (or equivalent) in Nursing, health-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 AM-4:30 PM Req ID: 210728 Salary Range/Pay Rate: $75,807.96  $101,077.28    

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 here.  

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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