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Coding Auditor - remote options available

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Date: Sep 10, 2017

Location: Atlanta, GA, US, 30329

Company: Children's Healthcare of Atlanta

Requisition #:  15996     
Name of Location:   Office Park (1687)
Work Schedule:  Day
Employment Type:  Full-Time
Work Days:  Monday - Friday 

 

JOB SUMMARY

Performs audits to promote organizational integrity of billing and coding for professional services. Evaluates the accuracy of ICD/CPT/HCPCS and other third-party payor codes. Verifies adequacy of documentation in support of services billed, including teaching physician guidelines, medical necessity, and compliance with other documentation, coding, and billing standards.

EDUCATION

  • High school diploma or equivalent

CERTIFICATION SUMMARY

  • CPC
  • CCS-P
  • CCA
  • CCS
  • CPC-H

EXPERIENCE*

  • 5 years of experience in healthcare, including 3 years of experience in physician practice coding, documentation, billing, and/or reimbursement

PREFERRED QUALIFICATIONS*

  • Coursework or degree

KNOWLEDGE SKILLS & ABILITIES*

  • Proficient in Microsoft Office, including Word and Excel
  • Experienced problem-solver
  • Demonstrated customer focus
  • Excellent written and verbal communications skills
  • Maintains current knowledge of federal and state regulations and guidelines, CMS and other third-party payor billing rules, and OIG compliance standards

JOB RESPONSIBILITIES*

  1. Conducts coding, billing, and documentation compliance audits within established timeframe and in accordance with the standards defined by Children's Healthcare of Atlanta.
  2. Prepares a report of findings and recommendations for improvement for each audit.
  3. Serves as a subject matter expert on coding/billing topics.
  4. Researches issues/questions and responds to internal inquiries.
  5. Assists the Physician Auditor Coordinator with developing a detailed audit plan for area being reviewed.
  6. Meets audit productivity standard.
  7. Meets annual requirements to maintain coding certification.

SYSTEM RESPONSIBILITIES*

Safety: Practices proper safety techniques in accordance with hospital and departmental policies and procedures. Responsible for the reporting of employee/patient/visitor injuries or accidents, or other safety issues to the supervisor and in the occurrence notification system.

 

Compliance: Monitors and ensures compliance with all regulatory requirements, organizational standards, and policies and procedures related to area of responsibility. Identifies potential risk areas within area of responsibility and supports problem resolution process. Maintains records of compliance activities and reports compliance activities to the Compliance Office.

 

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification.  They are not intended to be an exhaustive list of all job duties performed by the personnel so classified.

PHYSICAL DEMANDS*

Bending/Stooping - Occasionally (activity or condition exists up to 1/3 of time)

Climbing - Occasionally (activity or condition exists up to 1/3 of time)

Lifting - Occasionally (activity or condition exists up to 1/3 of time)

Pushing/Pulling - Occasionally (activity or condition exists up to 1/3 of time)

Sitting - Frequently (activity or condition exists from 1/3 to 2/3 of time)

Standing - Occasionally (activity or condition exists up to 1/3 of time)

Walking - Occasionally (activity or condition exists up to 1/3 of time)

Ability to lift up to 15 lbs independently not to exceed 50 lbs without assistance

Hearing/Speaking - Effective communication with employees, supervisors/managers and staff. Effective communications with patients and visitors, as required.

WORKING CONDITIONS*

Some potential for exposure to blood and body fluids

 

 

Location Address:  1687 Tullie Circle, Atlanta, GA  30329
Function:  Revenue Cycle - Coding

 

 

Overview:

Children’s Healthcare of Atlanta has been 100 percent dedicated to kids for more than 100 years. A not-for-profit organization, Children’s is dedicated to making kids better today and healthier tomorrow.

With 3 hospitals, 27 neighborhood locations and a total of 575 beds, Children’s is the largest healthcare provider for children in Georgia and one of the largest pediatric clinical care providers in the country. Children’s offers access to more than 60 pediatric specialties and programs and is ranked among the top children’s hospitals in the country by U.S. News & World Report.

Children’s has been ranked on Fortune magazine’s list of “100 Best Companies to Work For” for eleven consecutive years and named one of the “100 Best Companies” by Working Mother magazine. We offer a comprehensive compensation and benefit package that supports our mission, vision and values. We are proud to offer an array of programs and services to our employees that have distinguished us as a best place to work in the country.  Connect to our mission of being Dedicated to All Better and impact the lives of hundreds of thousands of patients and their families each year.


Nearest Major Market: Atlanta

Job Segment: Medical, Pediatric, Medical Coding, Healthcare