Coding and Compliance Auditor/Educator

Northside Hospital-posted 9 months ago
Full-time
Atlanta, GA
Hospitals
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Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.

  • Review medical record documentation to ensure correct CPT, ICD-10, and HCPCS codes and modifiers for selected claims.
  • Follow Northside policy and procedure for annual audit schedules for both physicians and practices.
  • Complete professional reports of findings and deliver results to physicians and leadership.
  • Interpret and review medical record documentation to ensure accurate coding based on provider documentation.
  • Provide education to providers, practice staff, and coders based on audit results.
  • Demonstrate knowledge of sequencing diagnoses and procedures as outlined in the Official Coding Guidelines.
  • Apply current coding and billing regulations, policies, processes, and procedures with effective decision-making and problem-solving skills.
  • Maintain an accuracy rate of 90% or above for all work Quality Assurance reviews.
  • Complete assigned work in a timely manner and maintain departmental production standards.
  • Maintain open communication with Auditing Supervisor.
  • Proficient in public speaking, presentations, and educational activities.
  • Assist the Revenue Cycle Support Coordinator in setting prices for services and performing market rate studies.
  • Assist Coordinators in Decision Support with projects involving analysis of patient charges and chart documentation.
  • B.S. degree in Nursing, Health Information Management, Healthcare Administration, or Business Administration.
  • 8 - 10 years of relevant work experience may be substituted for a B.S. degree.
  • Must have a coding or nursing credential (RHIA, RHIT, CPC, CCS, RN) or a financial background.
  • Minimum of 1 year hospital and/or physician practice coding experience.
  • Demonstrated communication skills and ability to work independently.
  • Knowledge of Microsoft Office products.
  • Certified Professional Medical Auditor (CPMA).
  • Three to five years' experience in a hospital and/or physician practice setting.
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