Wellstar Health System
Coding Compliance Auditor & Educator
Wellstar Health System, Atlanta, Georgia, United States, 30383
How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence, and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to be a shining example of what is possible when dedicated professionals make a difference in healthcare and people's lives.
Job Summary:
Under the direction of the Coding Compliance Manager, conducts independent audits of professional fee coding. Ensures appropriate and accurate coding assignments in accordance with federal regulations and guidelines. Prepares reports of findings and leads meetings with providers to review audit results and recommend improvements. Provides assistance with coding inquiries from providers and staff. Requires knowledge of Medicaid and Medicare regulations, physician documentation, coding, and billing across various specialties. Advanced knowledge of CPT, ICD-10-CM, and HCPCS coding systems is essential. Responsibilities include providing ICD-10-CM and EMR documentation training to physicians.
Core Responsibilities and Essential Functions:
Performs Audits:
Independently review medical records to verify documentation supports codes in compliance with standards, policies, laws, and regulations.
Communicate audit findings clearly to physicians and staff, including references to authoritative guidance.
Conduct research on compliance and coding issues.
Schedule and conduct meetings with providers.
Ensure Coding Compliance:
Assist in creating and updating coding reference materials and training presentations.
Stay current with laws, rules, and regulations through ongoing education and certification maintenance.
Additional Activities:
Communicate trends, issues, and needs to management.
Maintain accurate records of time spent on assignments.
Minimum Education:
Associate's Degree in a healthcare-related field from an accredited college required; Bachelor's Degree preferred.
Licenses and Certifications:
Certified Professional Coder (CPC) required.
Certified Coding Specialist (CCS) preferred.
Certified Professional Medical Auditor (CPMA) preferred upon hire.
Experience:
Minimum 5 years of auditing or coding compliance experience in a physician practice, or
Minimum 7 years of coding or revenue cycle experience in outpatient coding.
Skills:
High accuracy in coding and attention to detail.
Effective verbal and written communication skills, including public speaking and educational activities.
Objective problem-solving skills.
Extensive knowledge of Medicare regulations and documentation guidelines.
Professional appearance and demeanor when working with physicians.
Ability to learn quickly, work independently, and manage time effectively.
Proficiency in Microsoft Word, Excel, PowerPoint, and Outlook.
Ability to maintain confidentiality of sensitive information.
Join us and discover a supportive environment for meaningful work and a rewarding career. Connect with Georgia’s most integrated health system and start a future that offers more.
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Job Summary:
Under the direction of the Coding Compliance Manager, conducts independent audits of professional fee coding. Ensures appropriate and accurate coding assignments in accordance with federal regulations and guidelines. Prepares reports of findings and leads meetings with providers to review audit results and recommend improvements. Provides assistance with coding inquiries from providers and staff. Requires knowledge of Medicaid and Medicare regulations, physician documentation, coding, and billing across various specialties. Advanced knowledge of CPT, ICD-10-CM, and HCPCS coding systems is essential. Responsibilities include providing ICD-10-CM and EMR documentation training to physicians.
Core Responsibilities and Essential Functions:
Performs Audits:
Independently review medical records to verify documentation supports codes in compliance with standards, policies, laws, and regulations.
Communicate audit findings clearly to physicians and staff, including references to authoritative guidance.
Conduct research on compliance and coding issues.
Schedule and conduct meetings with providers.
Ensure Coding Compliance:
Assist in creating and updating coding reference materials and training presentations.
Stay current with laws, rules, and regulations through ongoing education and certification maintenance.
Additional Activities:
Communicate trends, issues, and needs to management.
Maintain accurate records of time spent on assignments.
Minimum Education:
Associate's Degree in a healthcare-related field from an accredited college required; Bachelor's Degree preferred.
Licenses and Certifications:
Certified Professional Coder (CPC) required.
Certified Coding Specialist (CCS) preferred.
Certified Professional Medical Auditor (CPMA) preferred upon hire.
Experience:
Minimum 5 years of auditing or coding compliance experience in a physician practice, or
Minimum 7 years of coding or revenue cycle experience in outpatient coding.
Skills:
High accuracy in coding and attention to detail.
Effective verbal and written communication skills, including public speaking and educational activities.
Objective problem-solving skills.
Extensive knowledge of Medicare regulations and documentation guidelines.
Professional appearance and demeanor when working with physicians.
Ability to learn quickly, work independently, and manage time effectively.
Proficiency in Microsoft Word, Excel, PowerPoint, and Outlook.
Ability to maintain confidentiality of sensitive information.
Join us and discover a supportive environment for meaningful work and a rewarding career. Connect with Georgia’s most integrated health system and start a future that offers more.
#J-18808-Ljbffr