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

Prisma Health

69d ago

0FinanceGreenville, SC, USjobspy_indeed
remoteindeed

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 Pointe**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.