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Wellstar Health System · 1 week ago

Coding Compliance Auditor & Educator

Atlanta, GA

Full-time

Onsite

Senior Level

5+ years exp

Wellstar Health System is dedicated to enhancing the health and well-being of every person they serve. The Coding Compliance Auditor & Educator will conduct independent audits of professional fee coding, ensuring compliance with federal regulations and providing training to physicians on documentation and coding practices.

FitnessHealth Care

Responsibilities

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

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

Qualification

CPT codingICD-10-CM codingHCPCS codingCoding compliance auditingMedicare regulations knowledgeMedicaid regulations knowledgePublic speakingMicrosoft Office proficiencyAttention to detailEffective communicationProblem solvingTime management

Required

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

Cert Coding Spec 1.00

Minimum 5 years auditing or coding compliance experience in a physician practice

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

Must maintain a professional appearance and demeanor while working with physicians

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