Compliance Auditor, Educator

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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

• Conduct independent audits of professional fee coding and medical record documentation • Ensure coding assignments comply with federal regulations, guidelines, organizational policies, laws, and professional standards • Prepare and communicate clear, accurate audit findings to physicians and charge review staff • Lead meetings with providers to review audit findings and recommend improvements • Provide assistance with coding inquiries from providers and coding staff • Research compliance and coding issues • Schedule meetings with providers • Create and update coding reference materials and presentations • Provide ICD-10-CM and EMR documentation training to physicians • Participate in professional education activities and maintain relevant certifications • Communicate trends, issues, and needed assistance to management • Maintain accurate records of time spent on assignments

🎯 Requirements

• Associate's Degree from an accredited college required, or minimum experience in lieu of an associate's degree • Bachelor's Degree from an accredited college in a healthcare-related field required • Minimum 5 years of auditing or coding compliance experience in a physician practice, or minimum 7 years of coding or billing (Revenue Cycle) experience in a physician or outpatient coding environment • Certified Professional Coder certification required • Certified Coding Specialist certification required • Advanced knowledge of CPT, ICD-10-CM, and HCPCS coding systems • Knowledge of applicable Medicaid and Medicare regulations • Knowledge of physician documentation, coding, and billing in a variety of settings and specialties • Certified Professional Medical Auditor (CPMA) preferred upon hire • High degree of coding accuracy and attention to detail • Ability to communicate complicated coding and compliance concepts verbally and in writing • Proficiency in public speaking, presentations, and educational activities • Extensive knowledge of Medicare regulations, documentation guidelines, and federal and state laws concerning clinical documentation, coding, and reimbursement • Ability to learn quickly and work independently on complex issues • Excellent time management, flexibility, adaptability, prioritization, and deadline management • Strong knowledge of Microsoft Word, Excel, PowerPoint, and Outlook • Ability to maintain confidentiality of sensitive information • Professional appearance and demeanor when working with physicians