Openings >> Audit Coder-Trauma Full Time
Audit Coder-Trauma Full Time
Summary
Title:Audit Coder-Trauma Full Time
ID:2181
Department:PRD
Location:Main Clinic--Columbus, GA
Description

The Hughston Clinic, The Hughston Foundation, The Hughston Surgical Center, Hughston Clinic Orthopaedics, and Jack Hughston Memorial Hospital participate in E-Verify. This company is an equal opportunity employer that recruits and hires qualified candidates without regard to race, religion, color, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or protected veteran status. This company is a VEVRAA Federal Contractor.

Position Goal: Streamline Trauma charge entry processes enabling, to ensure all eligible charges for services rendered by trauma providers are captured and are supported by documentation within the medical record.

 

Position Responsibilities:

  • Assigns ICD-10 CM and CPT4 diagnosis and procedure codes based on provider medical documentation for Surgical/Hospital services.
  • Ensures proper code assignment is entered/billed in billing system.
  • Ensures timely submission of claims to the responsible party to include resolving claim submission holds in Athena.
  • Finalize claims for submission to responsible party.
  • Perform monthly internal coding and documentation audits of billed services both in the hospital and in clinic setting.
  • Utilizes internal policies as well as application of coding concepts, AMA, CMS/OIG/Federal/State regulations and guidelines to perform all duties.
  •  Develop final audit reports based on findings/observations during the audit process to present to providers or other appropriate staff members.
  • Help identify areas for audit opportunities based on industry performance, regulatory focus areas and risk areas within the organization
  • Assists with development of educational program to support providers on coding accuracy and documentation  improvement
  • Perform monthly reconciliation of charges entered into PMD and Athena against Hospital reports
  • Direct interaction with physician to discuss audit findings, charge lag findings outside of timeframes dictated by Executive Management and all other conversation of concerns having a direct impact on revenue
  • Maintains 95% or greater accuracy rate.
  • Navigation of hospital management software
  • Performs other duties as assigned by Management.
Experience: Two years prior healthcare office billing experience required.
Education: High school diploma or equivalent required. Completion of approved orthopedic coding course with current coding certification.  CPC required.
Special Qualifications: Must be able to work independently. Strong attention to detail required
This opening is closed and is no longer accepting applications
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