Professional Billing Quality Coding Auditor, FT, Days,

Prisma HealthGreenville, South Carolina

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Overview

Schedule

Full-time

Education

Medical Coding (CCA, CCS, CCS-P, CPC)

Career level

Senior-level

Remote

On-site

Benefits

Career Development

Job Description

Inspire health. Serve with compassion. Be the difference.

Job Summary

Performs routine and specialty reviews of coders to ensure accurate coding. Prepares a summary of findings and presents reports to leadership on a monthly basis. Assists with training coders on identified opportunities for improvement. Assists in preventing coding denials.

Essential Functions

All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference.
Performs multi-specialty reviews for the Medical Group validating the CPT, ICD-10, modifiers and HCPCS codes using official coding guidelines and CMS guidelines and prepares a summary of findings.
Performs review of all coders within the department and prepares a summary of findings.
Provides training to coders on identified issues found during reviews.
Codes charges for professional billing based on review of clinical documentation.
Identifies and assists with the resolution of coding issues and process improvement.
Assists in creating edits to prevent denials.
Assists in creating a standardized process for front end coding including the development of training materials.
Mentors and trains coders on correct coding guidelines.
Interacts with other departments to assist in resolving coding.
Performs other duties as assigned.

Supervisory/Management Responsibilities

This is a non-management job that will report to a supervisor, manager, director or executive.

Minimum Requirements

Education- Bachelor's degree in Business or related field of study
Experience- Three (3) years multi-specialty coding experience in professional billing

In Lieu Of

Required Certifications, Registrations, Licenses

CPC Certified Professional Coder (AAPC) and
CPMA Certified Professional Medical Auditor (AAPC)

Knowledge, Skills and Abilities

Knowledge of medical terminology and basic anatomy and physiology with the ability to apply coding concepts to ensure correct coding.
Analytical skills.
Working knowledge of Epic, Encoder Pro, 3M
Ability to work independently and manage multiple projects consistently
Proficient computer skills (word processing, spreadsheets, database)
Data entry skills

Work Shift

Day (United States of America)

Location

Independence Pointe

Facility

7001 Corporate

Department

70019178 Medical Group Coding & Education Services

Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

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FAQs About Professional Billing Quality Coding Auditor, FT, Days, Jobs at Prisma Health

What is the work location for this position at Prisma Health?

This job at Prisma Health is located in Greenville, South Carolina, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.

What pay range can candidates expect for this role at Prisma Health?

Employer has not shared pay details for this role.

What employment applies to this position at Prisma Health?

Prisma Health lists this role as a Full-time position.

What experience level is required for this role at Prisma Health?

Prisma Health is looking for a candidate with "Senior-level" experience level.

What education level is required for this job?

The education requirement for this position is Medical Coding (CCA, CCS, CCS-P, CPC). Candidates with relevant qualifications or equivalent experience may also be considered.

What benefits are offered by Prisma Health for this role?

Prisma Health offers Career Development for this position. Actual benefits may vary depending on the employer's policies and employment terms.

What is the process to apply for this position at Prisma Health?

You can apply for this role at Prisma Health either through Sonara's automated application system, which helps you submit applications 10X faster with minimal effort, or by applying manually using the direct link on the job page.