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Prisma Health · 1 month ago

Professional Billing Quality Coding Auditor, FT, Days, - Remote

United States

Full-time

Remote

Mid Level

3+ years exp

Prisma Health is dedicated to transforming healthcare for the benefit of the communities they serve. The Professional Billing Quality Coding Auditor will support the Medical Group Coding and Education department by performing routine reviews of coders to ensure accurate coding and assisting with training and process improvement.

Health CareHospitalMedical

Responsibilities

Performs multi-specialty reviews for the Medical Group validating the CPT, ICD-10, modifiers and HCPCS codes using official coding guidelines and CMS guidelines and prepares a summary of findings

Performs review of all coders within the department and prepares a summary of findings

Provides training to coders on identified issues found during reviews

Codes charges for professional billing based on review of clinical documentation

Identifies and assists with the resolution of coding issues and process improvement

Assists in creating edits to prevent denials

Assists in creating a standardized process for front end coding including the development of training materials

Mentors and trains coders on correct coding guidelines

Interacts with other departments to assist in resolving coding

Performs other duties as assigned

Qualification

CPC Certified Professional CoderCPMA Certified Professional Medical AuditorMulti-specialty coding experienceWorking knowledge of EpicAnalytical skillsMedical terminology knowledgeBasic anatomy knowledgeProficient computer skillsData entry skills