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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.
Accountabilities
Validate / Review codes for assigned provider(s) / Division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. 40%
Utilizes appropriate coding software and coding resources in order to determine correct codes. 15%
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%
Responsible for resolving all assigned pre-billing edits.15%
Maintain knowledge of governmentaland commercial payer guidelines. 5%
Assists with the Coding Education team to identify areas that need additional training. 5%
Communicates billing related issues to assigned supervisor / manager and participates in Denial meetings in order to improve overall billing when applicable. 10%
Supervisory / Management Responsibilities
This is a non-management job that will report to a supervisor, manager, director or executive.
Minimum Requirements
High School diploma or equivalent or post-high school diploma / highest degree earned
Associate Degree - Preferred
2 years - Professional coding only
Required Certifications / Registrations / Licenses
Certified Professional Coder-CPC
Required Knowledge & Skills
Basic computer skills
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
7002 Value-Based Care and Network Services
Department
70028459 HCC Coding 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.