Coding Compliance Auditor & Educator

Wellstar Health System; Atlanta (GA); Remote; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a Coding Compliance Auditor & Educator to ensure accurate coding in accordance with federal regulations. This role involves conducting audits, preparing reports, and providing training to physicians on documentation standards. The ideal candidate will have a strong background in coding compliance, excellent communication skills, and the ability to work independently. Join a team that values accuracy and compliance, and make a significant impact in the healthcare sector by supporting providers and enhancing coding practices.

Qualifications

• 5+ years of auditing or coding compliance experience required.
• Knowledge of Medicaid and Medicare regulations essential.

Responsibilities

• Conduct independent audits of professional fee coding.
• Prepare written reports and lead meetings with providers.
• Assist with coding inquiries from providers and staff.

Skills

High accuracy in coding

Effective communication skills

Proficiency in Microsoft Word

Proficiency in Microsoft Excel

Knowledge of Medicare regulations

Ability to work independently

Education

Associate's Degree

Bachelor's Degree in healthcare-related field

Tools

Microsoft PowerPoint

Microsoft Outlook

Job description

Join to apply for the Coding Compliance Auditor & Educator role at Wellstar Health System

1 month ago Be among the first 25 applicants

Join to apply for the Coding Compliance Auditor & Educator role at Wellstar Health System

Job Summary

Under the direction of the Coding Compliance Manager, conducts independent audits of professional fee coding. Ensures 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 improvements. Provides assistance with coding inquiries from providers and staff. Requires knowledge of Medicaid and Medicare regulations, physician documentation, coding, and billing across various settings. Advanced knowledge of CPT, ICD-10-CM, and HCPCS coding systems is essential. Responsibilities include providing ICD-10-CM and EMR documentation training to physicians.

Facility: VIRTUAL-GA

Core Responsibilities and Essential Functions

1. Performs Audits:
   • Conduct reviews on medical record documentation to support codes, in line with standards and regulations.
   • Communicate audit findings clearly to physicians and staff, referencing authoritative guidance.
   • Research compliance and coding issues.
   • Schedule meetings with providers.
2. Ensure Compliance with Coding Guidelines:
   • Assist in creating and updating coding reference materials.
   • Participate in education and training to stay current with laws and regulations, maintaining relevant certifications.
3. Other Activities:
   • Communicate with management about trends and issues.
   • Maintain accurate records of time spent on assignments.

Minimum Education

Associate's Degree from an accredited college required; or equivalent experience. A Bachelor's Degree in a healthcare-related field is preferred.

Licenses and Certifications

• Certified Professional Coder (CPC) – Required
• Certified Coding Specialist (CCS) – Required
• Certified Professional Medical Auditor (CPMA) – Preferred upon hire

Experience

• Minimum 5 years of auditing or coding compliance experience in a physician practice, or
• Minimum 7 years of coding or billing experience in a physician or outpatient setting.

Skills

• High accuracy in coding and attention to detail.
• Effective communication skills, both verbal and written.
• Proficiency in Microsoft Word, Excel, PowerPoint, Outlook.
• Knowledge of Medicare regulations, documentation guidelines, and federal/state laws.
• Ability to work independently, prioritize, and meet deadlines.
• Professional appearance and demeanor when working with physicians.