Coding Compliance Auditor & Educator
Company: Wellstar Health System, Inc.
Location: Atlanta
Posted on: April 16, 2024
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Job Description:
Facility: VIRTUAL-GA
Job Summary:
Under the direction of the Coding Compliance Manager, conducts
independent audits of professional fee coding. Assures appropriate
and accurate coding assignments in accordance with federal coding
regulations and guidelines. Prepares written reports of findings
and leads meetings with providers to review the audit findings and
recommend ways to improve when indicated. Also responsible for
providing assistance with coding inquiries from providers, coding,
staff, etc. This position requires knowledge of applicable
regulations for Medicaid and Medicare, as well as the principles of
physician documentation, coding, and billing in a variety of
settings and specialties. Also required is advanced knowledge of
CPT, ICD-10-CM, and HCPCS coding systems. Responsibilities also
include providing ICD-10-CM and EMR documentation training to
physicians.
Core Responsibilities and Essential Functions:
Performs Audits a.Independently conduct reviews/audits on the
adequacy of medical record documentation to support the codes
selected by clinicians in accordance with professional standards,
organizational policies and procedures, laws, and regulations.
b.Creates and communicates clear and accurate audit findings to
physicians and charge review staff which include references for
authoritative guidance. c.Performs research related to compliance
and coding issues. d.Schedules meetings with providers. Ensure
compliance with coding guidelines a.Assist in creating and updating
coding reference materials and presentations as needed. b.Pursues
education and training opportunities to assure compliance with
current laws, rules and regulations by participating in
professional education activities and obtaining and maintaining
relevant certifications. Other Activities (5) a.Communicate with
Management regarding trends, issues or assistance needed.
b.Maintains an accurate record of time spent on all
assignments.
Required Minimum Education:
Associate's Degree from an accredited college required or in lieu
of associates degree candidate must meet the minimum experience
Required
Bachelor's Degree from an accredited college in a healthcare
related field. Preferred
Required Minimum License(s) and Certification(s):
Cert Prof Coder 1.00 Required
Cert Coding Spec 1.00 Required
Additional Licenses and Certifications:
Certified Professional Medical Auditor CPMA Upon Hire Preferred
Required Minimum Experience:
Minimum 5 years auditing or coding compliance experience in a
physician practice Required or
Minimum 7 years coding or billing (Revenue Cycle) experience in a
physician or outpatient coding environment.
Required
Required Minimum Skills:
High degree of coding accuracy. Attention to detail
Ability to communicate effectively both verbally and in writing
complicated coding and compliance concepts and maintain effective
working relationships with physicians and staff.
Proficient in public speaking, presentations and educational
activities.
Objective and detailed approach to problem solving.
Extensive knowledge of Medicare regulations, documentation
guidelines, and other federal and state laws and regulations
concerning clinical documentation, coding, and reimbursement
required.
Must maintain a professional appearance and demeanor while working
with physicians. High degree of coding accuracy. Attention to
detail.
Must be able to learn quickly and work independently to address a
variety of complex issues.
Excellent time management skills required
Must be flexible and adapt well to change
Ability to work independently, prioritize work and meet
deadlines.
Strong Knowledge of Microsoft Word, Excel, PowerPoint and Outlook
is required.
Ability to maintain confidentiality of sensitive information.
Keywords: Wellstar Health System, Inc., Atlanta , Coding Compliance Auditor & Educator, Accounting, Auditing , Atlanta, Georgia
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