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Senior Medical Audit Analyst
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- Submission of quality data as required by State and National regulatory and accrediting bodies has major impact on MMC reputation and prominence in the health care industry.
- IP is responsible for the accuracy, consistency and quality of coding using recognized disease and procedure coding classifications (ICD-10, ICD-O, CPT- 4 HCPCS etc.)
- Evaluate correct sequencing of codes to ensure appropriate billing and reimbursement.
- Understand the role of coding based on Chart Review versus Charge Master assignment.
- Conduct performance improvement activities regarding coding accuracy, completeness, data quality and integrity; identify issues in correct sequencing of codes and assignment of grouper payment methodology,Collaborate with physician, nursing and other clinical staff and review agencies on responses to denials, and other issues and to obtain clarification on documentation of clinical care.
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