PB Coding Quality Auditor

Work Shift

Day shift, Monday-Friday, 8:00 AM to 5:00 PM. Regular full-time position.

Provides audits and reviews patient charts, corresponding ICD-10 CM, CPT-4 codes, modifiers, HCPCS 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.

• Minimum of 5+ years professional auditing experience

• Associates degree in Health Information Management or related field

• High school diploma or equivalent

• Certified Professional Coder (CPC)
• Certified Professional Medical Auditor (CPMA)
• Certified Coding Specialist – Physician-based (CCS-P)

• Knowledge of diagnosis-related group and ambulatory payment classification regulations
• Demonstrated knowledge of Inter Qual Criteria and Medicaid and managed care rules and regulations
• Strong analytical, organizational, and communication skills

• Manage inventory levels in Operating Room (OR & CVOR), ensuring adequate supply availability and minimal supply disruption.
• Manage Cath Lab and Interventional Radiology (IR) inventory levels to ensuring supply availability and minimal disruption to procedure areas.
• Conduct chart audits for compliance assessment and establish coding policy and procedure.
• Prepare a report of findings for each audit along with an action.
• Record and monitor corrections to the bill.
• Assist in designing continued education to address deficiencies.
• Plan and organize work assignments to complete audits efficiently.
• Identify problem situations or inadequate charge reconciliation procedures.
• Clearly document information to support findings and conclusions.
• Keep appropriate management personnel informed of any problems or unusual circumstances on a timely basis.
• Facilitate improvement in overall quality and completeness of medical records documentation.
• Provide documentation education.

Children’s Healthcare of Atlanta is an equal opportunity employer committed to providing equal employment opportunities to all qualified applicants and employees without regard to race, color, sex, religion, national origin, citizenship, age, veteran status, disability or any other characteristic covered by applicable law.

Used for remote worker assignment

Coding

Mid-Senior level

Full-time

Hospitals and Health Care