Prisma Health
10,000+ employees
🏥 Healthcare
⚕️ Healthcare Insurance
Healthcare • Healthcare Insurance
Prisma Health is a comprehensive health care provider offering a wide range of medical services to ensure individuals achieve their healthiest state. With numerous locations, advanced technology, and expert specialists, Prisma Health provides accessible and convenient care. Services include primary care, specialized heart, cancer, women's, and children's health, as well as same-day and telehealth options. Prisma Health emphasizes community outreach and education to support overall health and wellness.
Professional Billing Quality Coding Auditor
đź•’ August 11
🌴 South Carolina – Remote
⏰ Full Time
🟡 Mid-level
đźź Senior
🔎 Auditor
🦅 H1B Visa Sponsor
đź‘» Ghost score 45%
Where this job comes from
Posted on Prisma Health's careers page, not through a job board
First seen by Remote Rocketship August 11
Prisma Health
10,000+ employees
🏥 Healthcare
⚕️ Healthcare Insurance
Healthcare • Healthcare Insurance
Prisma Health is a comprehensive health care provider offering a wide range of medical services to ensure individuals achieve their healthiest state. With numerous locations, advanced technology, and expert specialists, Prisma Health provides accessible and convenient care. Services include primary care, specialized heart, cancer, women's, and children's health, as well as same-day and telehealth options. Prisma Health emphasizes community outreach and education to support overall health and wellness.
đź“‹ 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
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