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Prisma Health

Professional Billing Quality Coding Auditor, FT, Days, - Remote

Remote — United States (see country and timezone requirements)

Check who can apply and the requirements below before continuing.

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

NA

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 PointeFacility

7001 CorporateDepartment

70019178 Medical Group Coding & Education ServicesShare 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.

Originally posted on Himalayas

Who can apply

Eligible countries: United States. Accepted UTC offsets: UTC-10, UTC-9, UTC-8, UTC-7, UTC-6, UTC-5, UTC+14. Review the full description for employer-specific work authorization, residency and schedule requirements.

Ready for your next step?Apply on the official website
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