Coding Quality Auditor - Physician Billing

Children's Healthcare of Atlanta in Atlanta, GA

  • Industry: Accounting - Accounts Payable/Accounts Receivable/Bookkeeping
  • Type: Full Time
  • $189,980.00 - 189,980.00
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Work Schedule/Days: Day / Monday - Friday
Employment Type: Full-Time
Location: Office Park (1644)
Requisition #: 34396
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*
  • Conducts chart audits for compliance assessment and establishes coding policy and procedure.
  • Prepares a report of findings for each audit along with an action plan.
  • Records and monitors corrections to the bill.
  • Assists in designing continued education to address deficiencies.
  • Plans and organizes work assignments to complete audits in an efficient manner.
  • Identifies problem situations or inadequate charge reconciliation procedures.
  • Clearly documents information to support findings and conclusions.
  • Keeps appropriate management personnel informed of any problems or unusual circumstances on a timely basis.
  • Facilitates improvement in the overall quality and completeness of medical records documentation.
  • Provides documentation education.
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*
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 - Constantly (activity or condition exists 2/3 or more 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, 27 neighborhood locations and a total of 638 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 70 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 fourteen 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 making kids better today and healthier tomorrow.

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

Address: 1644 Tullie Circle, Atlanta, GA 30329
Function: Revenue Cycle - Patient Financial Services
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