Job Description
Note:
The job is a remote job and is open to candidates in USA. Prisma Health is dedicated to transforming healthcare for the benefit of the communities they serve. The
Professional Billing Quality Coding Auditor will support the Medical Group Coding and Education department by performing routine reviews of coders to ensure accurate coding and assisting with training and process improvement. Responsibilities • 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 Skills • Bachelor's degree in Business or related field of study • Three (3) years multi-specialty coding experience in professional billing • CPC Certified
Professional Coder (AAPC) • CPMA Certified
Professional Medical Auditor (AAPC) • 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 Company Overview • Prisma Health is the largest not-for-profit health organization in South Carolina, serving more than 1.2 million patients annually.
It was founded in 2017, and is headquartered in Greenville, South Carolina, USA, with a workforce of 10001+ employees. Its website is Apply tot his job