Job Summary
Responsible for validating/reviewing and assigning applicable CPT, ICD-10, Modifiers and HCPCS codes for inpatient, outpatient and physicians office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines for multi-specialty medical practice(s). Communicates with providers and team members regarding coding issues.
Essential Functions
- Validate/Review codes for assigned provider(s)/Division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. 40%
- Responsible for resolving all assigned pre-billing edits.15%
- Utilizes appropriate coding software and coding resources in order to determine correct codes. 15%
- Communicates billing related issues to assigned supervisor/manager and participates in Denial meetings in order to improve overall billing when applicable. 10%
- Participates in coding educational opportunities (webinars, in house training, etc.). 5%
- Provides timely feedback to providers in order to clarify and resolve coding concerns. 5%
- Maintain knowledge of governmental and commercial payer guidelines. 5%
- Assists with the Coding Education team to identify areas that need additional training. 5%
- 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
- Experience - 2 years - Professional coding only
In Lieu Of
Required Certifications, Registrations, Licenses
- Certified Professional Coder-CPC (Preferred)
Knowledge, Skills and Abilities
- Knowledge of office equipment (fax/copier)
- Proficient computer skills including word processing, spreadsheets, database and data entry
- Mathematical skills
Work Shift
Day (United States of America)
Location
Independence Pointe
Facility
7001 Corporate
Department
70019178 Medical Group Coding & Education ServicesShare 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.
