Risk Adjustment Coder Professional Billing II, 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

Tuition/Education Assistance

Job Description

Inspire health. Serve with compassion. Be the difference.

Job Summary

Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission.

Essential Functions

All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference.
Conducts prospective review of charts to identify HCC opportunity.
Conducts retrospective review of charts to confirm documentation supports reporting.
Utilizes payor specific software to assist in capturing HCCs.
Communicates with providers about HCC opportunities for improvement.
Identifies suspect conditions that would potentially support reporting an HCC.
Participates in education offerings
Participates in monthly meetings
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- High School diploma or equivalent or post-high school diploma / highest degree earned. Associate degree preferred
Experience- Five (5) years professional fee coding experience

In Lieu Of

Required Certifications, Registrations, Licenses

Certified Professional Coder (CPC), and
Certified Risk Adjustment Coder(CRC)

Knowledge, Skills and Abilities

Knowledge of office equipment (fax/copier)
Proficient computer skills including word processing, spreadsheets, database
Data entry skills
Mathematical skills

Work Shift

Day (United States of America)

Location

Patewood Memorial Hospital

Facility

7002 Value-Based Care and Network Services

Department

70028459 HCC Coding 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 Risk Adjustment Coder Professional Billing II, 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 following benefits: Career Development and Tuition/Education Assistance 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.