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Coding Auditor
WellSpan Medical Group
Ephrata, USA
Full-time
Mid · 3+ years experience
Onsite
Discovered 4 days ago
Full Job Posting
Qualifications
- Qualifications Minimum Education:
- Associates Degree Required
- Work Experience:
- 3 years Coding/Auditing experience. Required
- Licenses:
- Certified Professional Coder Upon Hire Preferred or
- Certified Coding Specialist Upon Hire Preferred or
- Certified Coding Specialist - Physician Based Upon Hire Preferred
- Knowledge, Skills, and Abilities:
- Extensive knowledge of ICD-9/ICD-10 and CPT coding principles and guidelines.
- Excellent written/oral communication and computer skills.
- Works effectively in a team environment.
- Benefits Offered:
- Comprehensive health benefits
- Retirement savings plan
- Paid time off (PTO)
- Education assistance
- Financial education and support, including DailyPay
- Expanded Paid Parental Leave
- For additional details: Benefits & Incentives | WellSpan Careers (joinwellspan.org)
Responsibilities
- Duties and Responsibilities Essential Functions:
- Performs proactive or reactive coding compliance reviews as needed to identify or quantify potential issues.
- Investigates and recommends action to be taken when compliance issues are found. Monitors implementation of recommended corrective action and performs follow up reviews where necessary.
- Assists with coding compliance implementation throughout the WellSpan.
- Assists in the development and dissemination of education and training processes for the employees regarding coding compliance related activities.
- Assists with any investigations in accordance with the investigation protocol established by the organization.
- Assists in responding to questions, issues, concerns and reports of possible coding or billing misconduct reported or identified through the coding hotline, Help Desk calls, or other reporting lines.
- Supports the organization's commitment to comply with all federal, state, and local standards, with an emphasis on prevention of fraud and abuse.
- Promotes and adheres to the Code of Conduct and the elements of the Compliance Program and exercises due diligence to ensure compliance with policies and legal requirements.
- Prepares written reports pertaining to determinations and recommendations resulting from routine audits and/or assigned special projects. Presents report to appropriate managers and boards.
- Provides guidance to Enterprise Applications for documentation, coding and billing, including the creation of system billing edits.
- Common Expectations:
- Maintains established policies and procedures, objectives, quality assessment and safety standards.
- Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.
- Maintains appropriate records, reports, and files as required.
- Participates in administrative staff meetings and attends other meetings as assigned.
- Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.
- Travel Requirements:
- Estimated Amount: - Travel required.
- Essential Functions:
Preferred Qualifications
- Certified Professional Coder Upon Hire Preferred or
- Certified Coding Specialist Upon Hire Preferred or
- Certified Coding Specialist - Physician Based Upon Hire Preferred
About WellSpan Medical Group
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