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

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

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All team members are expected to be knowledgeable and compliant with Prisma Health 's purpose: Inspire health. Serve with compassion. Be the difference.

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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.

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Performs review of all coders within the department and prepares a summary of findings.

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Provides training to coders on identified issues found during reviews.

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Codes charges for professional billing based on review of clinical documentation.

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Identifies and assists with the resolution of coding issues and process improvement.

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Assists in creating edits to prevent denials.

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Assists in creating a standardized process for front end coding including the development of training materials.

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Mentors and trains coders on correct coding guidelines.

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Interacts with other departments to assist in resolving coding.

- Performs other duties as assigned.

Supervisory/Management Responsibilities
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This is a non-management job that will report to a supervisor, manager, director or executive.

Minimum Requirements

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Education - Bachelor's degree in Business or related field of study

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Experience - Three (3) years multi-specialty coding experience in professional billing

In Lieu Of
- NA

Required Certifications, Registrations, Licenses

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CPC Certified Professional Coder (AAPC) and

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CPMA Certified Professional Medical Auditor (AAPC)

Knowledge, Skills and Abilities

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Knowledge of medical terminology and basic anatomy and physiology with the ability to apply coding concepts to ensure correct coding.

- Analytical skills.

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Working knowledge of Epic, Encoder Pro, 3M

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Ability to work independently and manage multiple projects consistently

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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 .

Originally posted on Himalayas