Professional Billing Quality Coding Auditor

🔥 0 minutes ago

🌴 South Carolina – Remote

🌴 South Carolina – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

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Prisma Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2017

🏥 Healthcare

💰 Grant on 2024-08

Healthcare

Prisma Health is a large integrated health system that operates hospitals, clinics, and related patient services in South Carolina and Tennessee. The organization employs nearly 32,000 people and focuses on providing clinical care, nursing and allied health services, and workforce training (e. g. , nurse residency programs), with an emphasis on patient-centered care and community health. The company posts career opportunities across administrative, clinical, technical, and support roles and highlights benefits, hiring events, and candidate resources on its careers site.

📋 Description

• Perform multi-specialty reviews for the Medical Group, validating CPT, ICD-10, modifiers, and HCPCS codes using official coding and CMS guidelines • Prepare summaries of coding review findings and present reports to leadership monthly • Review all coders within the department • Train and mentor coders on identified issues and correct coding guidelines • Code professional billing charges based on clinical documentation • Identify and help resolve coding issues and improve processes • Assist in creating edits to prevent coding denials • Assist in creating standardized front-end coding processes and training materials • Interact with other departments to resolve coding issues • Perform other duties as assigned

🎯 Requirements

• Bachelor's degree in Business or related field of study • Three years of multi-specialty coding experience in professional billing • CPC Certified Professional Coder certification from AAPC • CPMA Certified Professional Medical Auditor certification from AAPC • Knowledge of medical terminology and basic anatomy and physiology • Ability to apply coding concepts to ensure correct coding • Analytical skills • Working knowledge of Epic, Encoder Pro, and 3M • Ability to work independently and manage multiple projects consistently • Proficient computer skills in word processing, spreadsheets, and databases • Data entry skills