PB Coding Quality Auditor

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Work Shift

Day

Work Day(s)

Monday-Friday

Shift Start Time

8:00 AM

5:00 PM

Regular

Children’s is one of the nation’s leading children’s hospitals. No matter the role, every member of our team is an essential part of our mission to make kids better today and healthier tomorrow. We’re committed to putting you first, and that commitment is at the heart of our company culture: People first. Children always. Find your next career opportunity and make a difference doing what you love at Children’s.

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.

Experience

• Minimum of 5+ years professional auditing experience

Preferred Qualifications

• Associates degree in Health Information Management or related field

Education

• High school diploma or equivalent

Certification Summary

Minimum of one of the following:

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

Knowledge, Skills, and Abilities

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

Job Responsibilities

• 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.
• Conducts chart audits for compliance assessment and establishes coding policy and procedure.
• Prepares a report of findings for each audit along with an action plan.
• Records and monitors corrections to the bill.
• Assists in designing continued education to address deficiencies.
• Plans and organizes work assignments to complete audits in an efficient manner.
• Identifies problem situations or inadequate charge reconciliation procedures.
• Clearly documents information to support findings and conclusions.
• Keeps appropriate management personnel informed of any problems or unusual circumstances on a timely basis.
• Facilitates improvement in the overall quality and completeness of medical records documentation.
• Provides 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