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Job Summary
To ensure 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
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%
Reviews and responds to coding questions submitted by physicians and coding staff within a timely manner. - 15%
Communicates billing related issues to assigned supervisor/manager. - 10%
Shadows provider and coding staff to confirm coding is supported by medical record documentation and identify opportunities to improve upon documentation and coding. - 5%
Participates in workshops, seminars, webinars, and other educational opportunities to ensure continued learning. Maintain current certification(s) and working knowledge if ICD-10 and CPT coding guidelines. - 5%
Recommends changes to billing procedures to achieve compliance with applicable laws, rules and regulations. - 5%
Obtains and maintains instructor status for AAPC PMCC Coding Curriculum, if applicable. Coordinates class schedule and provides instruction for the PMCC Coding Curriculum offered by the AAPC, if applicable. - 5%
Maintains knowledge if state and federal regulatory guidelines related to proper coding. - 5%
Participates in meetings with Corporate Compliance in order to identify opportunities for improvement. Schedules education sessions with providers to provide education based on audit findings, if applicable. - 5%
Participates in A/R Meetings in order to improve overall coding when applicable. - 5%
Supervisory/Management Responsibilities
- This is a non-management job that will report to a supervisor, manager, director or executive.
Minimum Requirements
- Bachelor's Degree - Business or related field of study
- 3 years - Professional Billing Coding or combined Coding/Billing
Required Certifications/Registrations/Licenses
- CPC - CERT PROFESSIONAL CODER
In Lieu of the Above Minimum Requirements
- Associate's Degree with 5 years of coding or coding/billing experience in a professional billing setting. High School Diploma with 7 years coding or coding/billing experience in a professional billing setting.
Other Required Skills and Experience
- Data Entry - required
Work Shift
Day (United States of America)Location
1200 Colonial Life BlvdFacility
3001 Medical Group AdministrationDepartment
30019178 Coding & EducationShare 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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