Job Description

Inspire health. Serve with compassion. Be the difference.

Job Summary

Responsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines. Serves as a subject matter expert for assigned specialty.

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.
• Abstracts/codes for assigned provider(s)/division(s) based on medical record documentation. Adheres to all coding and compliance guidelines.
• Utilizes appropriate coding software and coding resources in order to determine correct codes.
• Communicates billing related issues to assigned supervisor/manager and participates in meetings in order to improve overall billing, when applicable.
• Follows departmental policies for charge corrections.
• Participates in coding educational opportunities (webinars, in house training, etc.).
• Provides feedback to providers in order to clarify and resolve coding concerns.
• Resolves assigned pre-billing edits.
• Assists in identifying areas that require additional training.
• Mentors and assists in training other coders and new team members
• 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

• NA

Required Certifications, Registrations, Licenses

• Certified Professional Coder (CPC)
• Specialty Certification from AAPC that correlates with assigned specialty

Knowledge, Skills and Abilities

• Maintain knowledge of governmental and commercial payer guidelines.
• 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

Oconee Medical Campus

Facility

Corporate

Department

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.