• CPC Compliance Auditor (Analyst/Educator) - Remote Potential

    Job Locations USA-NY-New York
    Posted Date 1 month ago(3/18/2019 11:17 AM)
    Requisition ID
    Professional - Compliance & Audit
  • Company Overview

    At Memorial Sloan Kettering (MSK), we’re not only changing the way we treat cancer, but also the way the world thinks about it. By working together and pushing forward with innovation and discovery, we’re driving excellence and improving outcomes.
    For the 28th year, MSK has been named a top hospital for cancer by U.S. News & World Report. We are proud to be on Becker’s Healthcare list as one of the 150 Great Places to Work in Healthcare in 2018, as well as one of Glassdoor’s Employees’ Choice Best Place to Work for 2018. We’re treating cancer, one patient at a time. Join us and make a difference every day.

    Job Description

    The Compliance Department at MSK is seeking a Compliance Analyst/Educator to join their team. MSK’s Billing Compliance Department is focused on the prevention, detection and correction of fraud, waste and abuse by helping MSK employees adhere to MSK policies and government rules and regulations.


    As part of this focus, the Billing Compliance department develops an annual workplan of auditing, monitoring and educational activities to verify that the processes established to ensure compliant billing practices are working as intended. 


    As the Analyst/Educator, you will:

    • Analyze, oversee, and monitor physician documentation for compliance with billing, coding, and documentation rules, guidelines and MSK policy.
    • Analyze and assemble individual and service level audit results and perform QA of defined audit data to ensure accuracy and consistency.
    • Identify critical root cause errors by quantity, financial impact, and complexity of issue. Present results to clinicians, Service Chiefs and Service members and develop plan with clinicians and administration to address and resolve issues.
    • Independently initiate and implement monitoring plans based on root cause analysis.
    • Review and respond to inquiries relating to billing, coding, compliance and medical documentation concerns from clinicians, administrative staff, or third parties.
    • Meet with and train new clinicians on documentation guidelines.

    You have:


    • A Bachelor’s Degree (preferred) and a minimum of 4 year’s experience in billing, coding (particularly Evaluation and Management (E/M) services) and compliance audits.  Professional coding experience is required.
    • Expertise of billing and coding rules; ability to research billing, coding and compliance issues using various resources.      
    • Excellent communication skills (written and oral) and ability to present and train, both one-on-one or in small groups.
    • Excellent organizational and analytical skills; ability to develop reports.                       
    • Expertise in PC office applications.#LI-POST


    MSK is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sexual orientation, national origin, age, religion, creed, disability, veteran status or any other factor which cannot lawfully be used as a basis for an employment decision.  


    Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.


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