Ambulatory Coder III, Professional Billing, PT, Days, - Remote

Prisma Health; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

Prisma Health is seeking a skilled coder to abstract and validate CPT, ICD-10 and HCPCS codes across inpatient, outpatient, and physician settings, ensuring compliance with coding guidelines. A subject matter expert for the assigned specialty, you will stay updated on payer guidelines and coding updates.

The role requires five years of professional fee coding experience and CPC certification, with strong data entry and computer skills.

Qualifications

• 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
• Certifications - CPC and Specialty Certification from AAPC that correlates with assigned specialty
• Knowledge - Knowledge of governmental and commercial payer guidelines
• Skills - Proficient computer skills including word processing, spreadsheets, database; Data entry skills; Mathematical skills

Responsibilities

• Abstracts/codes for assigned provider(s)/division based on medical record documentation. Adheres to all coding and compliance guidelines.
• Utilizes appropriate coding software and coding resources to determine correct codes.
• Communicates billing issues to supervisor/manager and participates in meetings to improve billing.
• Follows departmental policies for charge corrections.
• Participates in coding educational opportunities (webinars, in-house training).
• Provides feedback to providers 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.

Skills

Five years coding experience

Data entry

Mathematical skills

Proficient computer skills

Payer guidelines knowledge

Education

High School diploma or equivalent

Associate degree preferred

Tools

Coding software

Office equipment

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

Independence Pointe

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.