Provider Coding Educator, FT, Days, - Remote

Prisma Health; Greenville (SC); Remote; USD 50,000 - 70,000; Full time

Job summary

Prisma Health is seeking a Coding Specialist to ensure accurate coding according to guidelines. The role involves educating staff, reviewing coding practices, and maintaining compliance with regulations. Ideal candidates will possess a Bachelor's degree and a CPC certification, along with relevant coding experience.

Qualifications

• 3 years of Professional Billing Coding or combined Coding/Billing experience.
• CPC - Certified Professional Coder required.

Responsibilities

• Educates providers and coding staff on proper coding.
• Reviews and responds to coding questions.
• Communicates billing-related issues.

Skills

Data entry skills

Education

Bachelor's Degree in Business or a related field

Associate degree with 5 years of coding or coding/billing experience

High School Diploma with 7 years of coding or coding/billing experience

Job description

Inspire health. Serve with compassion. Be the difference.

Job Summary

Ensures all provider services are completely and accurately coded according to approved coding guidelines. Provides coding support to the providers and staff by performing periodic coding reviews, conducting various coding education and training sessions.

Accountabilities

1. Educates providers and coding staff within the physician practice setting on proper CPT, ICD-10, and HCPCS coding. Performs random reviews of physician charges to identify opportunities for charge capture, ICD-10 specificity, and proper coding of all services rendered. - 40%
2. Reviews and responds to coding questions submitted by physicians and coding staff in a timely manner. - 15%
3. Communicates billing-related issues to the supervisor/manager. - 10%
4. Shadows provider and coding staff to confirm coding is supported by medical record documentation and identifies opportunities to improve documentation and coding. - 5%
5. Participates in workshops, seminars, webinars, and other educational opportunities to ensure continued learning. Maintains current certification(s) and working knowledge of ICD-10 and CPT coding guidelines. - 5%
6. Recommends changes to billing procedures to achieve compliance with applicable laws, rules, and regulations. - 5%
7. Obtains and maintains instructor status for AAPC PMCC Coding Curriculum, if applicable. Coordinates class schedules and provides instruction for the PMCC Coding Curriculum offered by the AAPC. - 5%
8. Maintains knowledge of state and federal regulatory guidelines related to proper coding. - 5%
9. Participates in meetings with Corporate Compliance to identify opportunities for improvement. Schedules education sessions with providers based on audit findings, if applicable. - 5%
10. Participates in A/R Meetings to improve overall coding when applicable. - 5%
11. Performs other duties as assigned.

Supervisory/Management Responsibilities

This is a non-management role reporting to a supervisor, manager, director, or executive.

Minimum Requirements

• Bachelor's Degree in Business or a related field of study
• 3 years of Professional Billing Coding or combined Coding/Billing experience

In Lieu Of

• Associate degree with 5 years of coding or coding/billing experience in a professional billing setting, or
• High School Diploma with 7 years of coding or coding/billing experience in a professional billing setting.

Required Certifications, Registrations, Licenses

• CPC - Certified Professional Coder

Knowledge, Skills, and Abilities

• Data entry skills

Work Shift

Day shift (United States of America)

Location

Independence Pointe

Facility

7001 Corporate

Department

70019178 Medical Group Coding & Education Services

Share your talent with us! Our vision is simple: to transform healthcare for the benefit of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.