Inspire health. Serve with compassion. Be the difference.
Ensures all provider services are completely and accurately coded according to approved coding guidelines. Provides coding support to the providers and staff by performing periodic coding reviews, conducting various coding education and training sessions.
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.
Educates providers and coding staff within the physician practice setting on proper CPT, ICD-10 and HCPCS coding. Performs random reviews of physician charges to identify opportunities for charge capture, ICD-10 specificity and proper coding of all services rendered.
Reviews and responds to coding questions submitted by physicians and coding staff within a timely manner.
Communicates billing related issues to assigned supervisor/manager.
Shadows provider and coding staff to confirm coding is supported by medical record documentation and identify opportunities to improve upon documentation and coding.
Participates in workshops, seminars, webinars, and other educational opportunities to ensure continued learning. Maintain current certification(s) and working knowledge if ICD-10 and CPT coding guidelines.
Recommends changes to billing procedures to achieve compliance with applicable laws, rules and regulations.
Obtains and maintains instructor status for AAPC PMCC Coding Curriculum, if applicable. Coordinates class schedule and provides instruction for the PMCC Coding Curriculum offered by the AAPC, if applicable.
Maintains knowledge if state and federal regulatory guidelines related to proper coding.
Participates in meetings with Corporate Compliance in order to identify opportunities for improvement. Schedules education sessions with providers to provide education based on audit findings, if applicable.
Participates in A/R Meetings in order to improve overall coding when applicable.
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 billing and/or coding experience
In Lieu Of
Associate degree with 5 years of coding or coding/billing experience in a professional billing setting. High School Diploma with 7 years coding or coding/billing experience in a professional billing setting.
Required Certifications, Registrations, Licenses
CPC - CERT PROFESSIONAL CODER
Knowledge, Skills and Abilities
Data entry skills
Work Shift
Day (United States of America)
Location
1200 Colonial Life Blvd
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.
Prisma Health is the largest not-for-profit health organization in South Carolina, serving more than 1.2 million patients annually. Our facilities in the Greenville and Columbia surrounding markets are dedicated to improving the health of all South Carolinians through improved clinical quality, access to care and patient experience, while also addressing the rising cost of health care.
Our Purpose: Inspire health. Serve with compassion. Be the difference.
