QA Compliance Specialist I, HIM

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 pursueour missionat MSK and around the globe.

Exciting Opportunity at MSK:QA Compliance SpecialistI, HIM

At Memorial Sloan Kettering, every role contributes to advancing world-class patient care, research, and operational excellence. As aQA Compliance Specialistwithin Health Information Management,you'llensure the accuracy, integrity, and regulatory compliance of clinical documentation and coding-strengthening revenue integrity, audit readiness, and data quality while supporting MSK's mission to end cancer for life.

Role Overview

• Perform compliance reviews and formal auditsvalidatingICD-10-CM/PCS, CPT-4, modifiers,FacilityEvaluation & Management, and medication administration coding.

• Ensureaccuratecoding and charge capture aligned with CMS, third-party payer, JCAHO, and HIPAA regulatory standards.

• Identifydocumentation gaps, trends, and risksimpactingcoding andbilling accuracy, compliance, and audit outcomes.

• Communicate findings and recommendations to HIM leadership, clinical teams,RevenueIntegrityand Patient Accounts partners.

• Coordinate and support external payer audits by preparing documentation and responding to data requests.

• Participate in special projects focused on data management, quality improvement, and process optimization.

• Maintain audit documentation, tracking tools, and reporting to support continuous compliance monitoring.

• Apply independent judgment whileoperatingwithin definedobjectivesand regulatory frameworks.

• Promote corrective actions and process enhancements to strengthen coding quality and operational consistency.

• Reviewand trackdenialsto ensurecoding accuracy based on documentation andcompliance withregulatory policies and standards.

Key Qualifications

• Minimum of 3 years of experience in medical terminology, anatomy and physiology, hospitalcoding andbilling, and medical records.

• Demonstratedexpertisewith ICD-10-CM/PCS, CPT, andFacilityEvaluation & Management coding.

• Hands-on experience conducting coding audits, compliance reviews, and regulatory validation activities.

• Working knowledge of healthcare regulatory requirements, including CMS guidelines and HIPAA standards.

• Proficiencyusing PC applications such as Microsoft Excel and Word for reporting, analysis, and documentation.

Core Skills

• Strong analytical and problem-solving abilities toidentifytrends, risks, and improvement opportunities in complex data sets.

• Clear, confident communication skills to present findings, provide guidance, and collaborate across multidisciplinary teams.

• High attention to detail and organizational discipline to manage large volumes of sensitive and complex information accurately.

• Ability to navigate multiple clinical, billing, and data systems while adapting to evolving workflows and regulations.

Additional Information:

• Location: Hybrid; when on site 633 Third Avenue in NYC (on site 4x a year)

• Schedule: Monday - Friday, 9 am - 5 pm (flexibility to start as early as 6:30 am)

• Reporting to: Manager, Health Information Management

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Closing:

At MSK, we believe in fair, competitive pay that reflects your job, experience, and skills.

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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