QA Compliance Specialist II, Health Information Management

Pay Range

$73,900.00-$114,400.00

Company Overview

The people of Memorial Sloan Kettering Cancer Center (MSK) are united by a singular mission: ending cancer for life. Our specialized care teams provide personalized, compassionate, expert care to patients of all ages. Informed by basic research done at our Sloan Kettering Institute, scientists across MSK collaborate to conduct innovative translational and clinical research that is driving a revolution in our understanding of cancer as a disease and improving the ability to prevent, diagnose, and treat it. MSK is dedicated to training the next generation of scientists and clinicians, who go on to pursue our mission at MSK and around the globe. 

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Job Description

QA 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 NYC
• Schedule: Monday – Friday, 9 am – 5 pm (flexibility to start as early as 6:30 am)
• Reporting to the Manager 1, Health Information Management

Pay Range: $73,900.00 – $114,400.00/annually

Helpful Links:

• MSK Compensation Philosophy
• Review Our Greats Benefits Offerings

Closing

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. 

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