Overview

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

“Remote work available depending on location"

Responsibilities

Under direction of the Manager of Coding Assurance/Compliance, reviews chart documentation to ensure coders have appropriate coding and DRG assignment, discharge disposition, admit and discharge dates and reimbursement. Educate staff when errors are identified. Coordinates payment corrections with the assistance of the Billing and Revenue Cycle team:

Audit hospital and/or physician medical records and charges to ensure compliance with coding and regulatory standards. Conduct medical record reviews to ensure accurate, ethical documentation, coding, charging and billing practices. Support and provide coding and compliance training to coding staff, physicians, clinical personnel, billing, and/or other hospital staff. Establish effective communication with coding staff, physicians, clinical staff, and/or hospital staff to address documentation, coding, and reimbursement issues. Educate coding staff, 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. Ability to work remotely and independently with self-driven focus on job completion.
Document work processes as required.

This position will be 100% remote. 

Qualifications

Required Minimum Education

• Bachelor or Associate-level degree in Health Information Management, Business, or other health care related field preferred (years’ experience may be considered in lieu of same)

Required Minimum Experience

• Five years inpatient coding experience required with one to two years of hospital-based outpatient services coding experience and one-year inpatient coding audit experience preferred
• A combination of 5 years of comparable experience with hospital coding, billing and reimbursement experience may be substituted for an Associate's degree

Required Minimum Certification

At least one of the following:

• Registered Health Information Administrator (RHIA)
• Registered Health Information Technician (RHIT)
• Certified Coding Specialist (CCS)
• Certified Professional Coder-Hospital (CPCH).
• An auditing credential is a plus.

Required Minimum Skills

• Excellent communication, organization, and educational skills
• Extensive knowledge of medical ton government payors
• Extensive experience with (electronic) meerminology, ICD-10-CM and ICD-10-PCS coding (as well as ICD-9-CM), CPT-4 procedural coding (including Level II HCPCS), and all coding and billing guidelines
• Hospital billing experience with focus dical record chart review and/or extraction, hospital billing
• Extensive experience with Medicare, Medicaid, and reimbursement rules and regulations
• Experience with management information systems and medical software
• Competence in Microsoft Word and Excel software in a Windows environment (Experience with Microsoft Access Is a plus)