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Coding Compliance Auditor, Educator
Wellstar Health System. Conduct independent audits of professional fee coding .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in auditing professional fee coding and ensuring compliance with federal regulations and guidelines. Proficient in providing training and clear communication of complex coding concepts to healthcare providers.
Highest-signal resume keywords
Certified Professional Coder CertificationCertified Coding Specialist CertificationICD-10-CM Proficiency5 Years Auditing ExperienceExtensive Knowledge of Medicare Regulations
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
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Hard Skills
AuditingCoding ComplianceMedical Record Documentation ReviewCoding AccuracyPublic SpeakingPresentation SkillsEducational TrainingResearching Coding IssuesTime ManagementAttention to Detail
Soft Skills
Effective CommunicationAdaptabilityConfidentialityProfessional Demeanor
Tools & Technologies
Microsoft WordMicrosoft ExcelMicrosoft PowerPointMicrosoft Outlook
Certifications & Qualifications
Certified Professional Coder CertificationCertified Coding Specialist CertificationCertified Professional Medical Auditor (CPMA)
Industry Keywords
Federal RegulationsClinical DocumentationCoding GuidelinesReimbursementHealthcare Compliance
About the role
Key responsibilities & impact- Conduct independent audits of professional fee coding
- Review medical record documentation to verify that clinician-selected codes are supported
- Ensure coding assignments comply with federal regulations, guidelines, organizational policies, and professional standards
- Prepare and communicate clear, accurate audit findings to physicians and charge review staff
- Reference authoritative coding and compliance guidance in audit findings
- Lead meetings with providers to review audit findings and recommend improvements
- Research coding and compliance issues
- Respond to coding inquiries from providers and coding staff
- Schedule meetings with providers
- Assist in creating and updating coding reference materials and presentations
- Provide ICD-10-CM and EMR documentation training to physicians
- Pursue professional education and maintain relevant certifications
- Communicate trends, issues, and assistance needs to management
- Maintain accurate records of time spent on assignments
Requirements
What you’ll need- Associate's Degree from an accredited college required, or equivalent minimum experience in lieu of an associate degree
- Bachelor's Degree from an accredited college in a healthcare-related field preferred
- Certified Professional Coder certification required
- Certified Coding Specialist certification required
- Certified Professional Medical Auditor (CPMA) preferred upon hire
- Minimum 5 years auditing or coding compliance experience in a physician practice, or minimum 7 years coding or billing (Revenue Cycle) experience in a physician or outpatient coding environment
- High degree of coding accuracy and attention to detail
- Ability to communicate complicated coding and compliance concepts effectively verbally and in writing
- Proficiency in public speaking, presentations, and educational activities
- Extensive knowledge of Medicare regulations, documentation guidelines, and federal and state laws and regulations concerning clinical documentation, coding, and reimbursement
- Ability to learn quickly and work independently on complex issues
- Excellent time management skills
- Ability to adapt to change, prioritize work, and meet deadlines
- Strong knowledge of Microsoft Word, Excel, PowerPoint, and Outlook
- Ability to maintain confidentiality of sensitive information
- Professional appearance and demeanor when working with physicians
Benefits
Comp & perks- Full-time employment
- Day shift
- Support to do meaningful work
- More rewarding life