Ambulatory Coder III, FT, Days, - Remote

Prisma Health; Seneca (SC); On-site; USD 65,000 - 90,000; Full time

Job summary

Prisma Health in Oconee Medical Campus is seeking an experienced medical coder to abstract and validate CPT, ICD-10 and HCPCS codes across inpatient, outpatient, and clinic settings, ensuring compliance with coding guidelines and payer requirements.

You will use coding software, resolve pre-billing edits, mentor peers, and participate in training. A CPC and specialty certification, plus five years of professional fee coding experience, are required.

Qualifications

• Education: High School diploma or equivalent; Associate degree preferred.
• Experience: Five years professional fee coding experience.
• Certifications: CPC and specialty certification related to assigned specialty.

Responsibilities

• Abstracts and validates CPT, ICD-10 and HCPCS codes for inpatient, outpatient and clinic settings.
• Adheres to coding and compliance guidelines and communicates issues as needed.
• Utilizes coding software and resources to determine correct codes.
• Mentors and trains other coders and new staff.
• Performs other duties as assigned.

Skills

Data entry

Analytical thinking

Payer guidelines knowledge

Proficient computer skills

Education

High School diploma or equivalent

Associate degree preferred

Tools

Coding software

Job description

• Follows departmental policies for charge corrections.

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, Licenses

• 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

Oconee Medical Campus

Facility

Corporate

Department

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.