Coding Compliance Auditor, Educator

🔥 4 hours ago

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Wellstar Health System

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1992

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Wellstar Health System is a comprehensive healthcare organization dedicated to providing personalized and compassionate care to patients in Georgia and South Carolina. With a diverse range of career opportunities, Wellstar supports its employees' career growth and wellbeing through a positive culture, excellent benefits, and a focus on diversity, equity, and inclusion. The organization emphasizes the importance of treating both patients and staff with respect and care, making it a sought-after workplace in the healthcare industry. Wellstar is committed to offering high-quality healthcare services and maintaining strong community engagement.

📋 Description

• 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. • Provides assistance with coding inquiries from providers, coding, staff, etc. • 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. • Creates and communicates clear and accurate audit findings to physicians and charge review staff which include references for authoritative guidance. • Performs research related to compliance and coding issues. • Schedules meetings with providers. Ensure compliance with coding guidelines a. Assist in creating and updating coding reference materials and presentations as needed. • 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. • Communicate with Management regarding trends, issues or assistance needed. • Maintains an accurate record of time spent on all assignments.

🎯 Requirements

• Associate's Degree from an accredited college required or in lieu of associates degree candidate must meet the minimum experience • Bachelor's Degree from an accredited college in a healthcare related field. • Cert Prof Coder 1.00 Required • Cert Coding Spec 1.00 Required • Certified Professional Medical Auditor CPMA Upon Hire Preferred • 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. • 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. • Strong Knowledge of Microsoft Word, Excel, PowerPoint and Outlook is required. • Ability to maintain confidentiality of sensitive information.

🏖️ Benefits

• Competitive salary • Health insurance • 401(k) matching • Flexible work hours • Paid time off