Reimbursement Auditor
Wellstar Health Systems


Job Info


Overview

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Responsibilities

Under direction of the Director of Revenue Management Department, this position is responsible for performing defensive, concurrent, retrospective and patient requested bill audits to determine accuracy of billed charges. Provide timely answers to patient questions to enhance customer service. Interact with all hospital departments with lost charge problems and provide education on issues to prevent reoccurrence. Complete and review productivity and
departmental reports.

Qualifications

Required Minimum Education: Graduate of accredited Registered Nursing program with license to practice in Georgia.

Required Minimum Experience: 2 years Acute Care Nursing Experience along with Charge Capture Audit, Medical Coding, Reimbursement Case Management or Revenue Cycle Experience

Required Minimum Certification: Register Nurse License in the State of Georgia

Required Minimum Skills: Computer/data entry experience. Ability to communicate with various members of the healthcare team. Ability to use EXCEL, Word and have basic computer operational knowledge. Epic and 3M experience preferred. Must be organized and multi-task oriented. Self-directed, able to work independently. Ability to communicate clearly and professionally with staff at all levels in the organization and external customers. General knowledge of medical claims submission process for non-government insurance carriers. Ability to interpret managed
care contracts and understanding of general terminology. Able to navigate CMS Website and Manuals. Able to interpret CPT/HCPCS and ICD-10 codes. Maintains professional licensure.

We'd like to invite you on a career journey like no other! In return for your contributions, we'll help you make the most of all life's moments - on and off the job. Wellstar Total Rewards is designed to provide for your total well-being, including: Your Wellness, Your Pay, Your Future, Your Joy. We think it's pretty simple - we care for our team members and our team members care for the community.

Make a difference in patients' lives... and your own! Here, it's more than healthcare - it's CareerCare!



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