Coding Compliance Auditor/Physician EducatorSouthwest Health, Platteville, WI
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Southwest Health is a non-profit health care system offering residents of southwest Wisconsin a broad span of medical services through its various facilities, including a hospital in Platteville, and Southwest Behavioral Services as well as Epione Pavilion in Cuba City.
We are a model healthcare organization, providing the highest quality care at the lowest possible cost while working to create healthier communities.
We are committed to quality health care. Proof of this committment is our accreditation by the Joint Commission on Accreditation of Health Care Organizations. We've been awarded full accreditation because we strive to provide the best care possible, and we've proven it by meeting the Joint Commissions's standards for high quality care. Our Long Term Care Facility has also successfully completed two consecutive years of deficiency free surveys by the Department of Health and Family Services - Bureau of Quality Assurance.
Our hospital features birthing suites, 24-hour a day emergency services, complete diagnostic services, an out-patient specialty clinic, community health programs, comprehensive rehabilitation services (physical, occupational, speech therapies), and respiratory therapy services to name just a few.
Coding Compliance Auditor/Physician Educator
- High school diploma, GED, or equivalent required.
- Completion of a recognized course of study for health information practitioners or coding specialists.
- Certification in CCS, CCS-P, RHIA, RHIT, CPC, or specialty coding.
- Three years’ experience in clinic charge capture process review, medical record review, and claims auditing experience with clinic background, and in working with regulatory and policy compliance issues related to federal and state programs.
- Three years’ experience in clinic working with electronic patient financial management and medical records information systems and manual processes outside of these electronic systems, with significant exposure to healthcare coding/billing/reimbursement.
- Knowledge of managed care and third-party payer benefits designs and reimbursement requirements.
We are seeking a full-time Coding Compliance Auditor/Physician Educator to work Monday-Friday in our HIM department.
The Coding Compliance Auditor/Physician Educator is responsible for obtaining, interpreting, analyzing and communicating information regarding physician reimbursement legislation and third party regulations on an on-going basis, and focusing on potential opportunities and issues by specialty; training new providers and faculty staff, and providing continuing education in coding and billing of specialty services and third party regulations; reviewing medical records for regulatory compliance with the payers; reviewing remittance advice statements for rejection resolution and inappropriate charges and payments, and devising solutions; and providing information and training on regulatory inconsistencies; developing and/or revising divisional templates to ensure complete and accurate billing that reflect current demands of all regulatory bodies; assisting in accurate implementation and maintenance of the Electronic Medical Record system regarding coding and billing; assisting with establishing consistent coding and billing practices throughout Southwest Health, as needed or requested; providing local and national advocacy of coding and billing solutions through membership organizations, and participation in seminars/conferences.
We believe that together we can change lives, and we anticipate your life will change in the process. If you aspire to help others find hope and live better, we invite you to submit your application at www.southwesthealth.org.
SH is truly an outstanding place to work. A full benefit package is available for employees working 20 hours/week or greater which includes: Health, Dental, Vision and Life insurance. Also available are long and short term disability, cell phone discount, flexible spending plan, paid time off, retirement plan with an employer contribution, fitness membership discount as well as use of exercise equipment at the facility.
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Paid Sick Leave
|Years of Experience||2-5 Years|