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Job Summary
Responsible for validating/reviewing and assigning applicable CPT, ICD-10, Modifiers and HCPCS codes for inpatient, outpatient and physicians office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines for multi-specialty medical practice(s). Communicates with providers and team members regarding coding issues.
Accountabilities
Validate/Review codes for assigned provider(s)/Division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. 40%
Responsible for resolving all assigned pre-billing edits.15%
Utilizes appropriate coding software and coding resources in order to determine correct codes. 15%
Communicates billing related issues to assigned supervisor/manager and participates in Denial meetings in order to improve overall billing when applicable. 10%
Participates in coding educational opportunities (webinars, in house training, etc.). 5%
Provides timely feedback to providers in order to clarify and resolve coding concerns. 5%
Maintain knowledge of governmental and commercial payer guidelines. 5%
Assists with the Coding Education team to identify areas that need additional training. 5%
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
High School diploma or equivalent or post-high school diploma / highest degree earned. Associate degree – Preferred
2 years – Professional coding only
In Lieu Of
NA
Required Certifications, Registrations, Licenses
Certified Professional Coder-CPC
Knowledge, Skills and Abilities
Knowledge of office equipment (fax/copier)
Proficient computer skills including word processing, spreadsheets, database and data entry
Mathematical skills
Work Shift
Day (United States of America)
Location
100 N Sumter St Sumter
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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