Ambulatory Coder Denials, FT, Days, - Remote

Overview

Inspire health. Serve with compassion. Be the difference.

Responsible for validating coding and facilitation of appeals process for all assigned denied professional service claims. All team members are expected to be knowledgeable of payer guidelines related to coding and appeal timelines. Communicates with providers regarding coding denial issues. Ensures documentation supports CPT, Modifiers, HCPCS and ICD-10 codes for submitted appeals, reopenings, reconsiderations, etc.

Essential Functions

• All team members are expected to be knowledgeable and compliant with Prisma Health\'s values : Inspire health. Serve with compassion. Be the difference.
• Responsible for working coding claim denials accurately and timely in accordance with performance and productivity goals.
• Utilizes appropriate coding software and coding resources in order to determine correct codes.
• Communicates billing related issues
• Follows departmental policies for charge corrections.
• Participates in coding educational opportunities (webinars, in house training, etc.).
• Provides feedback to providers or appropriate office liaison in order to clarify and resolve coding concerns.
• Submits appeals for assigned payer and / or division.
• Assists with Compliance Team and Coding Educators to identify areas that require additional training
• Participates in meetings in order to improve overall billing
• Performs other duties as assigned.

Supervisory / Management Responsibilities

Minimum Requirements

In Lieu Of

Required Certifications, Registrations, Licenses

Knowledge, Skills and Abilities

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.

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