Ambulatory Coder III, FT, Days, - Remote

Prisma Health; Oregon; Hybrid; USD 65,000 - 95,000; Full time

Job summary

Prisma Health in Greenville Memorial Hospital seeks a skilled coder to abstract and validate CPT, ICD-10 and HCPCS codes across inpatient, outpatient and clinic settings. You will ensure compliance with coding guidelines and stay current with payer rules.

Key duties include coding based on documentation, using coding software, communicating issues to leadership, and mentoring junior coders. Requires CPC certification and an AAPC specialty credential with at least five years of professional fee

Qualifications

• CPC certification and AAPC specialty credential.
• Minimum five years of professional fee coding experience.
• Experience abstracting/validating CPT, ICD-10 and HCPCS codes in hospital, outpatient, and physician settings.
• Knowledge of government and commercial payer guidelines.

Responsibilities

• Abstracts/codes for assigned providers based on documentation.
• Uses coding software to determine correct codes.
• Communicates billing issues to supervisor and participates in meetings to improve billing.
• Follows departmental policies for charge corrections.
• Participates in coding educational opportunities.
• Provides feedback to providers to clarify coding concerns.
• Resolves assigned pre-billing edits.
• Mentors and assists in training other coders and new team members.
• Performs other duties as assigned.

Skills

Payer guidelines

Data entry

Computer skills

Education

High School Diploma

Associate degree preferred

Tools

Coding software

Job description

Inspire health. Serve with compassion. Be the difference.

Job Summary

Responsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines. Serves as a subject matter expert for assigned specialty.

Essential Functions

• All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference.
• Abstracts/codes for assigned provider(s)/division(s) based on medical record documentation. Adheres to all coding and compliance guidelines.
• Utilizes appropriate coding software and coding resources in order to determine correct codes.
• Communicates billing related issues to assigned supervisor/manager and participates in meetings in order to improve overall billing, when applicable.
• Follows departmental policies for charge corrections.
• Participates in coding educational opportunities (webinars, in house training, etc.).
• Provides feedback to providers in order to clarify and resolve coding concerns.
• Resolves assigned pre-billing edits.
• Assists in identifying areas that require additional training.
• Mentors and assists in training other coders and new team members
• 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 or post-high school diploma / highest degree earned. Associate degree preferred
• Experience - Five (5) years professional fee coding experience

In Lieu Of

• NA

Required Certifications, Registrations, Licences

• Certified Professional Coder (CPC)
• Specialty Certification from AAPC that correlates with assigned specialty

Knowledge, Skills and Abilities

• Maintain knowledge of governmental and commercial payer guidelines.
• Knowledge of office equipment (fax/copier)
• Proficient computer skills including word processing, spreadsheets, database
• Data entry skills
• Mathematical skills

Work Shift Day (United States of America)

Location Greenville Memorial HospitalFacility CorporateDepartment Medical Group Coding & Education Services

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