Facility: Wellstar MCG Health, Inc.

Job Summary:

Provides clinical documentation improvement, auditing, coding and charge entry for all Interventional Radiology, Imaging procedure and Neuro Intervention performed at WMCG Medical Imaging. This includes chart and report review and supply/implant inventory utilized. Reviews clinical documentation in the procedural event log and provides coding and compliance training to physicians, clinical personnel, billing and/or hospital staff. Conducts medical record reviews to ensure the accurate and appropriate documentation, coding, charging and billing practices to ensure compliance and to meet coding regulatory standards. Reviews documentation to ensure that the appropriate diagnostic and procedural ICD-10, CPT-4 and HCPCS codes can be assigned to the greatest specificity for appropriate reimbursement. Reviews and verifies that the coding, demographic, encounter and charge related information is entered correctly into the patient record. Works in conjunction with Epic Radiant team, Compliance, Revenue Management Department (RDM) and HIM departments for correct coding and billing of Clinical Trials and new procedures being evaluated and performed in Medical Imaging. Researches new procedures gathering information on CPT and DRG reimbursement, the cost of supplies required for the procedure and in-service opportunities for staff and physicians. Works with RMD to build charge codes for these new procedures and serves as Clinical and Coding Liaison. Collaborates with supply chain to ensure all new supplies are assigned proper SUP codes and item numbers. Troubleshoots issues that prevent charges from posting. Processes "Bill-Only" requisitions for supply items when needed. Creates charge sheets to be used for commonly performed procedures in the department and maintains them for any and all coding changes. Provides training to a back-up coding person for Medical Imaging Provides data to Management for financial analysis.

Core Responsibilities and Essential Functions:

Assists accounts receivable department with coding questions. Code services accurately using ICD-10 and CPT codes. Assigns CPT, HCPCS, ICD-10-CM, and DRG codes. Review accounts for insurance and patient follow-up. Responds to inquiries regarding invoices, payments, or account discrepancies. Work with Clinical Team on registration errors and multiple visit concerns relating to the department. Works with Radiology Management Team to identify cost recovery and cost reduction strategies. Review all notes for accuracy and completeness. Analyzes Charge Capture Reports. Makes recommendations for improving systems. Notifies Compliance department of any compliance violations that are discovered during the review process. Checks the hospital system's billing queues and accounts to ensure that all charges have been secured. Attends educational sessions and reads publications to stay up to date on changes regarding AMA and CMS documentation guidelines. Improves coding and abstracting job knowledge by attending training sessions, reading technical publications. Protects healthcare organization value by keeping information confidential, cautioning others regarding potential breaches. Performs other duties as assigned Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education:

• High School Diploma General or GED General or Associates Healthcare Informatics-Preferred
• Associates Nursing or Bachelors Nursing or Masters Nursing-Preferred

Required Minimum License(s) and Certification(s):

All certifications are required upon hire unless otherwise stated.

• CPC - Cert Prof Coder
• BLS-I - Basic Life Support - Instructor or BLS - Basic Life Support
• RN-COMPACT - RN - Multi-state Compact or RN - Reg Nurse (Single State)

Additional License(s) and Certification(s):

Certified Interventional Radiology Cardiovascular Coder (CIRCC) Upon Hire Preferred and Cert Prof Coder-Hospital OP Upon Hire Preferred

Required Minimum Experience:

Minimum 1 year Previous training in procedural coding and diagnostic coding Required and

Required Minimum Skills:

Ability to communicate with various members of the healthcare team High Basic experience and knowledge of PC applications (Word & Excel) High