Coding Prebill Auditor (Remote)

WellStar

Atlanta Georgia

United States

Accounting
(No Timezone Provided)

JOB DESCRIPTION

Overview


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.


Responsibilities


Ask you're recruiter today about sign on bonus opportunities up to $10,000 for this position!

The Coding Auditor is responsible for conducting prebill and retrospective reviews of selected accounts to include DRG`s, APC`s, diagnoses and procedures on accounts that are finalized by the coding staff. These audits are performed to insure that compliance with current coding guidelines and regulatory standards are being met. The auditor will actively participate in the selection of review issues. Evaluation of coding audits and close monitoring of external forces such as OIG, RAC, and CMS etc. is an important role of this position. The auditor will use their knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. They will employ critical thinking skills to alert coding leadership to any trends identified in their reviews and to make suggestions for continual process improvement. The auditor will provide written and verbal reports and analysis of their findings to be presented to coding leadership, coding staff as well as other leaders at WellStar.


Qualifications


Required Minimum Education

  • Bachelor or Associate degree in Health Information Management, Business, or other health care related field preferred

  • Required Minimum Certification

    At least one of the following:

  • Registered Health Information Administrator (RHIA)
  • Registered Health Information Technician (RHIT)
  • Certified Coding Specialist (CCS)
  • CertifiedProfessional Coder (CPC)
  • Certified Inpatient Coder (CIC)
  • Certified Outpatient Coder (COC)

  • Required Minimum Experience

  • Three years of hospital-based inpatient/outpatient services coding experience required
  • A combination of 5 years of comparable hospital coding experience may be substituted for an Associate's degree

  • Required Minimum Skills

  • Extensive knowledge of medical terminology, disease processes, pharmacology, and anatomy and physiology
  • Hospital experience with focus on government payors
  • Extensive experience with medical record chart review
  • Extensive experience with Medicare, Medicaid, and reimbursement rules and regulations
  • Experience with management information systems and medical software
  • Competent in Microsoft Word and Excel software in a Windows environment (Experience with Microsoft Access Is a plus)
  • Must demonstrate extensive experience with DRG assignment, and/or hospital outpatient coding of diagnosis and surgical procedures with some IVR experience preferred


  • We’d like to invite you on a career journey like no other! In return for your contributions, we’ll help you make the most of all life’s moments – on and off the job. Wellstar Total Rewards is designed to provide for your total well-being, including: Your Wellness, Your Pay, Your Future, Your Joy. We think it’s pretty simple – we care for our team members and our team members care for the community.

    Make a difference in patients’ lives… and your own! Here, it’s more than healthcare – it’s CareerCare!

    Coding Prebill Auditor (Remote)

    WellStar

    Atlanta Georgia

    United States

    Accounting

    (No Timezone Provided)

    JOB DESCRIPTION

    Overview


    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.


    Responsibilities


    Ask you're recruiter today about sign on bonus opportunities up to $10,000 for this position!

    The Coding Auditor is responsible for conducting prebill and retrospective reviews of selected accounts to include DRG`s, APC`s, diagnoses and procedures on accounts that are finalized by the coding staff. These audits are performed to insure that compliance with current coding guidelines and regulatory standards are being met. The auditor will actively participate in the selection of review issues. Evaluation of coding audits and close monitoring of external forces such as OIG, RAC, and CMS etc. is an important role of this position. The auditor will use their knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. They will employ critical thinking skills to alert coding leadership to any trends identified in their reviews and to make suggestions for continual process improvement. The auditor will provide written and verbal reports and analysis of their findings to be presented to coding leadership, coding staff as well as other leaders at WellStar.


    Qualifications


    Required Minimum Education

  • Bachelor or Associate degree in Health Information Management, Business, or other health care related field preferred

  • Required Minimum Certification

    At least one of the following:

  • Registered Health Information Administrator (RHIA)
  • Registered Health Information Technician (RHIT)
  • Certified Coding Specialist (CCS)
  • CertifiedProfessional Coder (CPC)
  • Certified Inpatient Coder (CIC)
  • Certified Outpatient Coder (COC)

  • Required Minimum Experience

  • Three years of hospital-based inpatient/outpatient services coding experience required
  • A combination of 5 years of comparable hospital coding experience may be substituted for an Associate's degree

  • Required Minimum Skills

  • Extensive knowledge of medical terminology, disease processes, pharmacology, and anatomy and physiology
  • Hospital experience with focus on government payors
  • Extensive experience with medical record chart review
  • Extensive experience with Medicare, Medicaid, and reimbursement rules and regulations
  • Experience with management information systems and medical software
  • Competent in Microsoft Word and Excel software in a Windows environment (Experience with Microsoft Access Is a plus)
  • Must demonstrate extensive experience with DRG assignment, and/or hospital outpatient coding of diagnosis and surgical procedures with some IVR experience preferred


  • We’d like to invite you on a career journey like no other! In return for your contributions, we’ll help you make the most of all life’s moments – on and off the job. Wellstar Total Rewards is designed to provide for your total well-being, including: Your Wellness, Your Pay, Your Future, Your Joy. We think it’s pretty simple – we care for our team members and our team members care for the community.

    Make a difference in patients’ lives… and your own! Here, it’s more than healthcare – it’s CareerCare!