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Prisma Health

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

Posted a day ago
5-10 years experience
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AI Summary

The Ambulatory Coder III is responsible for abstracting and validating CPT, ICD-10, and HCPCS codes for various healthcare settings while ensuring compliance with billing guidelines. They also serve as a subject matter expert, mentor team members, and resolve pre-billing edits to improve overall billing accuracy.

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.

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