Offer summary

Qualifications:

High School Diploma or GED required; Bachelor's in Health Administration preferred., Minimum of 3 years of professional billing, coding, and/or auditing experience required., Experience in coding for multiple specialties is preferred., Certification as a Professional Coder (CPC) is required..

Key responsabilities:

Conduct coding and provider documentation reviews for professional service encounters.

Document and report audit results to management and leadership.

Participate in meetings to discuss audit findings and educational opportunities.

Maintain knowledge of coding and billing requirements and perform production coding as needed.

Job description

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 have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Job Posting

A Brief Overview

As part of the Coding Audit and Education section within the HIM and Coding Division of Wellstar MCG, the Coding Auditor-Professional Services is responsible for conducting coding and provider documentation reviews for AU Health professional service encounters. Audits will include planned and triggered pre and post bill reviews to assess the quality of coding and documentation. Audit findings will drive process improvement and provider and coder education initiatives.

What you will do

Documents and reports all results to the Coding Managers/Directors and Coding Audit and Education Leadership. Organizes audit samples and accurately records audit findings using approved protocols, audit tools and worksheets. Reviews and answers questions regarding the audit findings in accordance with policies. Works closely with Coding, Audit, Compliance and Education Leadership to develop internal and external audit plans needed to enhance the overall auditing and education process. 30%
Follows policies and procedures, performs internal audits to determine professional coding and provider documentation compliance with established policies, guidelines, and regulations. Reviews provider documentation and provider entered CPT codes to determine compliance with provider billing requirements. Performs daily focused coding pre-bill and/or post-bill reviews using coding compliance software. 30%
Participates in audit, education, and coding team meetings to discuss results, corrective action, educational opportunities and performance dashboards. Communicates recommendations for identified educational opportunities based on audit findings as compared to applicable regulatory, compliance, and correct coding guidelines. Assists in the development of education sessions to Hospital Departments, Coders, and physicians related to audit findings. 15%
Maintains knowledge of coding and billing requirements and regulatory changes. Performs production coding of inpatient and clinic ambulatory professional service encounters as needed. 15%
Compliance with Patient/Family-Centered Care standards through the following: Demonstrates dignity and respect for patient and family for patient and family knowledge, values, beliefs, and cultural background in the planning and delivery of care. Provides information sharing, ensuring patients and families receive timely, complete, and accurate information in order to effectively participate in care and decision-making. Encourages patient and family participation in care and decision-making. 10%

Qualifications

High School Diploma General Required and(
GED General Required or
Bachelors Health Administration Preferred or)

Minimum 3 years professional billing, coding and/or auditing of medical records for multiple specialities Required
Minimum 3 years coding multi-specialities Preferred

CPC - Cert Prof Coder

Our people are passionate about what they do, the product they sell, and the customers they serve. If you're looking for an opportunity to be an opportunity to be a part of a work family that values collaboration, innovation and dedication, we're the right company for you.

Join us and discover the support to do more meaningful work—and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.

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