Ambulatory Coder III, Orthopedics, FT, Days, - Remote

Prisma Health; United States; Remote; USD 65,000 - 85,000; Full time

Job summary

Prisma Health is seeking a skilled Medical Coding Specialist to abstract and validate CPT, ICD-10, and HCPCS codes for inpatient, outpatient, and clinic settings. You will ensure compliance with coding guidelines and payer-specific rules while serving as a subject matter expert for the assigned specialty.

The role requires CPC certification, 5 years of professional fee coding experience, and the ability to mentor other coders.

Qualifications

• Education - High School diploma or equivalent; associate degree preferred.
• Five (5) years professional fee coding experience.
• Certified Professional Coder (CPC) required; specialty certification from AAPC related to assigned specialty.

Responsibilities

• Abstracts and codes for inpatient, outpatient, and clinic settings using coding software and guidelines.
• Adheres to governmental and commercial payer guidelines and coding/billing updates.
• Mentors and assists in training other coders and new team members; participates in education opportunities.
• Resolves pre-billing edits and communicates issues to supervisor/manager; supports provider feedback.

Skills

Data entry

Computer skills

Math skills

Knowledge of payer guidelines

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, 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

Patewood Outpt Ctr/Med Offices

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.