MEDICAL AUDIT ANALYST

$73,202 - $97,603/Yr

Albert Einstein College Of Medicine - Tarrytown, NY

posted 3 months ago

Full-time - Entry Level
Tarrytown, NY
Professional, Scientific, and Technical Services

About the position

The Medical Audit Analyst position at Montefiore Medical Center involves a critical role in reviewing and researching patient medical records to accurately document the reasons for admissions, treatments rendered, surgical procedures performed, and diagnoses at discharge. This position requires the application of appropriate coding from various classifications such as ICD-10 CM, PCS, and CPT-4, ensuring compliance with federal, state, and commercial insurance requirements. The analyst will work closely with physicians, nursing, and other clinical staff to ensure that the data is complete and that the codes applied accurately reflect the patient's status during hospitalization or visits. This role is essential for supporting optimal reimbursement and reporting, as well as for performance improvement initiatives within the organization. In addition to coding, the Medical Audit Analyst will abstract pertinent clinical data from medical records and enter this information into the appropriate data repositories. This data will be utilized for various purposes, including billing, research, education, and planning. The position requires a strong understanding of coding techniques and familiarity with electronic medical record systems, as well as a commitment to maintaining high standards of accuracy and compliance in all coding practices. The analyst will also be expected to obtain certified credentials within one year of employment if not already completed at the time of hire.

Responsibilities

  • Review and research patient medical records to document reasons for admission, treatment rendered, surgical procedures performed, and diagnoses at discharge.
  • Apply appropriate codes from coding classifications such as ICD-10 CM, PCS, and CPT-4 to accurately describe patient status during hospitalization or visits.
  • Ensure data completeness and accuracy in collaboration with physicians, nursing, and other clinical staff.
  • Support optimal reimbursement and compliance with federal, state, and commercial insurance requirements through accurate coding practices.
  • Abstract pertinent clinical data from medical records and enter it into appropriate data repositories for billing, research, and reporting purposes.

Requirements

  • High School Diploma or GED required.
  • Knowledge of coding techniques and familiarity with reviewing medical records in an electronic environment.
  • Completion of an industry-recognized curriculum in Coding using ICD-10 CM, ICD-10 PCS, and CPT-4.
  • Experience in a healthcare environment applying coding classifications and grouping methodologies such as DRGs.
  • Experience reviewing and abstracting records for patients in all levels of care in a complex healthcare environment.

Nice-to-haves

  • Certified credentials in medical coding (to be obtained within 1 year of employment).
  • Experience in Health Information Management (HIM) preferred.

Benefits

  • Competitive salary range of $73,202.07 - $97,602.77 based on experience and education.
  • Regular full-time employment status with a day shift schedule from 8:30 AM to 5 PM.
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