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. 

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