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Coding Quality Auditor

Work Schedule/Days:  Day / Monday - Friday
Employment Type:  Full-Time
Location:  Support I 
Requisition #:  55822

 

JOB SUMMARY

Provides audits and reviews patient charts, the corresponding ICD-9, CPT-4 codes, and charges for appropriateness. Provides reports to management of findings and recommendations for solutions. Identifies areas of improvement which will enhance internal controls and performance throughout Children’s Healthcare of Atlanta. Proactively supports the efforts that ensure safe patient care and services and promote a safe environment at Children's Healthcare of Atlanta. Works with management team to educate Coding staff on coding and documentation compliance.

EDUCATION

•High school diploma or equivalent

CERTIFICATION SUMMARY

•Registered Health Information Technologist (RHIT) , Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Professional Compliance Officer (CPCO), Certified Coding Specialist (CCS), or Licensed Practical Nurse (LPN)

EXPERIENCE*

•No minimum experience required

PREFERRED QUALIFICATIONS*

•Associate's degree in Health Information Management or related field
•1 year of experience in auditing with a healthcare organization or insurance company

KNOWLEDGE SKILLS & ABILITIES*

•Knowledge of diagnosis-related group and ambulatory payment classification regulations
•Demonstrated knowledge of InterQual Criteria and Medicaid and managed care rules and regulations
•Strong analytical, organizational, and communication skills
•Must be able to successfully pass the Basic Windows Skill Assessment at 80% or higher rating within 30 days of employment

JOB RESPONSIBILITIES*

1.Conducts chart audits for compliance assessment and establishes coding policy and procedure.
2.Prepares a report of findings for each audit along with an action plan.
3.Records and monitors corrections to the bill.
4.Assists in designing continued education to address deficiencies.
5.Plans and organizes work assignments to complete audits in an efficient manner.
6.Identifies problem situations or inadequate charge reconciliation procedures.
7.Clearly documents information to support findings and conclusions.
8.Keeps appropriate management personnel informed of any problems or unusual circumstances on a timely basis.
9.Facilitates improvement in the overall quality and completeness of medical records documentation.
10.Provides documentation education.

SYSTEM RESPONSIBILITIES*
PHYSICAL DEMANDS*
Ability to lift up to 15 lbs independently not to exceed 50 lbs without assistance
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)
Hearing/Speaking - Effective communication with employees, supervisors/managers and staff. Effective communications with patients and visitors, as required.
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 - Occasionally (activity or condition exists up to 1/3 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)
WORKING CONDITIONS*
No potential for exposure to blood and body fluids

 

About Us:

Children’s Healthcare of Atlanta has been 100 percent committed 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, 20 neighborhood locations and a total of 673 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 recognized as a Fortune 100 Best Place to Work, a Best Place for Working Mothers, and as a top employer for diversity and millennials.  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 making kids better today and healthier tomorrow. 

Have questions about the recruitment process?  Check out What to Expect.

Address:  1575 Northeast Expressway, Bldg 1, Atlanta, GA  30329
Function:  Revenue Cycle - Coding