Coding Auditor

Schedule

Full-time: 80hrs/biweekly

Hours: Monday - Friday, 8am - 4:30pm

Position is primarily remote. There are occasions that a team member may need to report to a WellSpan location for a meeting or presentation.

General Summary

Performs clinical documentation audits, evaluations and other reviews for the System to ensure and assess compliance with applicable laws and regulations. Prepares and presents written and oral reports summarizing audit work, issues identified and recommendations to correct issues to management. Develops and disseminates education and training programs to employees.

Duties and Responsibilities

• 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.

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

Flexible spending and health savings accounts

Retirement savings plan

Paid time off (PTO)

Short-term disability

Education assistance

Financial education and support, including DailyPay

Wellness and Wellbeing programs

Caregiver support via Wellthy

Childcare referral service via Wellthy