Wellstar Health System
Manager Hospital Coding Assurance - 10K Sign On Bonus Available!
Wellstar Health System, Atlanta, Georgia, United States, 30383
Manager Hospital Coding Assurance
Wellstar Health System is seeking a Manager of Hospital Coding Assurance to lead inpatient and outpatient coding audits, ensure compliance with federal regulations, and promote accurate reimbursement.
Job Summary Under the direction of the Director of Coding Assurance – Compliance, the Manager will execute the Compliance Plan, coordinate audits, develop training, and communicate findings to leadership.
Core Responsibilities
Lead Hospital Coding Assurance audit process, maintain audit controls and produce reports.
Develop training and educational materials for identified audit findings.
Support external audits and perform oversight of audit activities.
Ensure accurate, compliant coding/billing across hospital services.
Manage communication with Compliance and Coding leadership regarding documentation deficiencies, audit findings, and regulatory requirements.
Develop and coordinate the Annual Audit plan, review OIG workplan, and present findings to executive leadership.
Investigate coding/billing violations, develop corrective action plans, and maintain an active issues log.
Analyze data, select samples, utilize Microsoft Access and Excel to report findings and trends.
Provide post-review education to WellStar employees, management, and physicians.
Coordinate the Recovery Audit Contractor (RAC) process, develop workflows, and report RAC outcomes to leadership.
Lead multidisciplinary teams for performance improvement, analyze RAC data, and maintain integrity and compliance with all federal programs.
Required Minimum Education Bachelor’s Degree in Health Information Management, Business, or other health‑care related field.
Required Licenses and Certifications
Cert Coding Spec 1.00 – Required
Cert Coding Spec – Phys Based 1.00 – Required
Cert Prof Coder 1.00 – Required
Cert Prof Coder – Hospital OP 1.00 – Required
Reg Health Information Admin 1.00 – Required
Reg Health Information Tech 1.00 – Required
Required Experience
Minimum 5 years of inpatient auditing, and/or other related coding/billing/compliance experience.
Outpatient coding experience – Preferred.
Required Skills
Extensive knowledge of medical terminology, CPT‑4 procedural coding, ICD‑9‑CM, ICD‑10‑CM, ICD‑10‑PCS, and all coding/billing guidelines.
Hospital billing experience focused on government payors.
Experience with medical record chart review and extraction for hospital billing.
Experience with Medicare, Medicaid, and reimbursement rules and regulations.
Experience with management information systems and medical software.
Competent in Microsoft Word and Excel in a Windows environment; access experience is a plus.
Benefits Join Wellstar to serve with compassion, pursue excellence, and honor every voice. Discover meaningful work and a rewarding life.
Location Smyrna, GA (Remote options available). Salary: $55,000.00–$65,000.00 per year.
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Job Summary Under the direction of the Director of Coding Assurance – Compliance, the Manager will execute the Compliance Plan, coordinate audits, develop training, and communicate findings to leadership.
Core Responsibilities
Lead Hospital Coding Assurance audit process, maintain audit controls and produce reports.
Develop training and educational materials for identified audit findings.
Support external audits and perform oversight of audit activities.
Ensure accurate, compliant coding/billing across hospital services.
Manage communication with Compliance and Coding leadership regarding documentation deficiencies, audit findings, and regulatory requirements.
Develop and coordinate the Annual Audit plan, review OIG workplan, and present findings to executive leadership.
Investigate coding/billing violations, develop corrective action plans, and maintain an active issues log.
Analyze data, select samples, utilize Microsoft Access and Excel to report findings and trends.
Provide post-review education to WellStar employees, management, and physicians.
Coordinate the Recovery Audit Contractor (RAC) process, develop workflows, and report RAC outcomes to leadership.
Lead multidisciplinary teams for performance improvement, analyze RAC data, and maintain integrity and compliance with all federal programs.
Required Minimum Education Bachelor’s Degree in Health Information Management, Business, or other health‑care related field.
Required Licenses and Certifications
Cert Coding Spec 1.00 – Required
Cert Coding Spec – Phys Based 1.00 – Required
Cert Prof Coder 1.00 – Required
Cert Prof Coder – Hospital OP 1.00 – Required
Reg Health Information Admin 1.00 – Required
Reg Health Information Tech 1.00 – Required
Required Experience
Minimum 5 years of inpatient auditing, and/or other related coding/billing/compliance experience.
Outpatient coding experience – Preferred.
Required Skills
Extensive knowledge of medical terminology, CPT‑4 procedural coding, ICD‑9‑CM, ICD‑10‑CM, ICD‑10‑PCS, and all coding/billing guidelines.
Hospital billing experience focused on government payors.
Experience with medical record chart review and extraction for hospital billing.
Experience with Medicare, Medicaid, and reimbursement rules and regulations.
Experience with management information systems and medical software.
Competent in Microsoft Word and Excel in a Windows environment; access experience is a plus.
Benefits Join Wellstar to serve with compassion, pursue excellence, and honor every voice. Discover meaningful work and a rewarding life.
Location Smyrna, GA (Remote options available). Salary: $55,000.00–$65,000.00 per year.
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