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Job DescriptionQA Compliance Specialist II, Health Information Management
Exciting Opportunity at MSK: We are hiring a QA Compliance Specialist II to join our Health Information Management outpatient team.
Role Overview:
Monitor and maintain compliance by performing reviews and formal audits validating ICD-10-CM/PCS and/or CPT-4 codes, modifiers, as well as Evaluation/Management and medication administration for coding/charge processing. Communicate directly with HIM Leadership, clinical staff, Patient Accounts to ensure that clinical documentation is in compliance with CMS/other third party carriers, JCAHO and HIPAA standards/regulatory requirements. Participate/coordinate reviews of third party payors and provides documentation to fulfill external audit requests, as well as special projects involving data management. Work largely independently within defined objectives/responsibilities by operating at a multi-faceted level and promoting solutions.
Key Qualifications:
At least 4 years experience with medical terminology, anatomy & physiology, ICD10CM/PCS, CPT and/or EM coding, hospital billing, medical records..Core Skills:
Ability to express position/opinions in a team conversation in an effective manner.Understanding of hospital billing processes, including flow of data from clinical departments/HIM into billing systems.Ability to understand complex work assignments and government regulations, applying rules to reviews/audits; knowledge/ability to use PC applications, including Excel and Microsoft Word, to develop/analyze reports with the capability to recognize and recommend enhancements among the different systems.Analytic skills include basic math, statistics and problem solving techniques to identify trends.Ability to navigate through various clinical/charging applications/databases.Organizational skills and attention to detail, in order to effectively manage/maintain large amounts of complex data in an accurate/legible manner.Ability to effectively communicate with all staff in a clear, concise and professional manner, as well as explain/provide guidance and share information to less experienced staff.Additional Information:
Location: Hybrid; when on site 633 Third Avenue in NYCSchedule: Monday – Friday, 9 am – 5 pm (flexibility to start as early as 6:30 am)Reporting to the Manager 1, Health Information ManagementPay Range: $73,900.00 - $114,400.00/annually
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