Coding Assurance Analyst

November 23

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Wellstar Health System

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Cardiovascular • Pulmonary • Cancer • Women and Babies • Musculoskeletal

10,000+

Description

• Support and provide coding and compliance training to physicians, clinical personnel, billing, and/or other hospital staff • Establish effective communication with physicians, clinical staff, and/or hospital staff to address documentation, coding, and reimbursement issues • Conduct medical record reviews to ensure accurate, ethical documentation, coding, charging and billing practices • Audit physician and/or hospital medical records and charges to ensure compliance with coding and regulatory standards • Educate physicians, clinical staff, and/or hospital staff on appropriate documentation as required by medical review and governmental agencies • Develop written policies promoting WellStar's commitment to compliance and specific areas of potential fraud and abuse • Use knowledge of coding and compliance guidelines to identify potential billing / reimbursement issues • Participate in special audits as instructed • Work as a team member within Coding Assurance and all other departments • Document work processes as required • Perform other duties as assigned

Requirements

• High school diploma required • Bachelor's Degree in Health Information Management, Business preferred • Associate's Degree in Health Information Management, Business required or other healthcare related field preferred • Cert Coding Spec or Cert Coding Spec - Phys Based or Cert Prof Coder or Cert Prof Coder - Hospital OP or Reg Health Information Admin or Reg Health Information Tech required upon hire unless otherwise stated • Extensive knowledge of medical terminology, CPT-4 procedural coding (including Level II HCPCS), ICD-9-CM coding, and all coding and billing guidelines • Hospital or Physician billing experience with focus on government payors • Extensive knowledge of the Documentation Guidelines for Evaluation and Management (physician specific staff) • Extensive experience with medical record chart review and/or extraction for physician or hospital billing. • 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 • Must demonstrate extensive experience with coding of Evaluation and Management services (physician specific staff) and surgical procedures