Ambulatory Coding Specialist Denials II, FT, Days

1 week ago


Greenville, South Carolina, United States Prisma Health Full time

About Prisma Health

We are a leading healthcare organization that strives to transform healthcare for the benefit of our communities. At Prisma Health, we believe in the importance of compassionate care and continuous innovation.

Salary

The estimated salary for this position is $63,000 - $83,000 per year, depending on qualifications and experience.

Job Description

This is an exciting opportunity to join our team as an Ambulatory Coding Specialist Denials II In this role, you will be responsible for validating coding and facilitating the appeals process for all assigned denied professional service claims.

You will work closely with providers to communicate coding denial issues, ensuring that documentation supports CPT, Modifiers, HCPCS, and ICD-10 codes for submitted appeals, reopenings, reconsiderations, and more.

Responsibilities:

  • Validate coding and facilitate the appeals process for assigned denied claims.
  • Communicate with providers regarding coding denial issues.
  • Evaluate documentation to ensure support for CPT, Modifiers, HCPCS, and ICD-10 codes.
  • Utilize coding software and resources to determine correct codes.
  • Participate in coding educational opportunities to stay up-to-date on industry guidelines.
  • Provide timely feedback to providers or office liaisons to clarify and resolve coding concerns.
  • Submit appeals for assigned payers and divisions.
  • Maintain knowledge of governmental and commercial payer guidelines.
  • Assist with Compliance Team and Coding Educators to identify areas for additional training.
  • Communicate billing-related issues to supervisors or managers.

Requirements

  • Bachelor's degree in Health Information Management or related field (or equivalent experience).
  • Certified Professional Coder-CPC certification.
  • 2 years of professional coding experience (or combination of coding/billing experience).
  • Basic computer skills, including proficiency in word processing, spreadsheets, and data entry.

About You

We are looking for a highly skilled and detail-oriented individual who is passionate about coding and committed to delivering exceptional results. If you have a strong understanding of medical terminology, coding principles, and regulatory guidelines, we encourage you to apply for this exciting opportunity



  • Greenville, South Carolina, United States Prisma Health Full time

    We are seeking an experienced Ambulatory Coder Denials II to join our dynamic team at Prisma Health. As a key member of our Medical Group Coding & Education Services, you will play a crucial role in ensuring accurate coding and appealing denied claims.Job SummaryThis full-time, day shift position involves working closely with healthcare professionals to...


  • Greenville, South Carolina, United States Prisma Health Full time

    Transform healthcare with Prisma Health. We're seeking a skilled Ambulatory Coder Denials II to join our team.About the RoleThis full-time, day shift position is responsible for validating coding and facilitating appeals processes for denied professional service claims. The ideal candidate will possess knowledge of payer guidelines, coding software, and...


  • Greenville, South Carolina, United States Prisma Health Full time

    About the RoleWe are seeking a highly skilled Healthcare Systems Specialist to join our team at Prisma Health. As a key member of our pharmacy team, you will play a critical role in ensuring the efficient and effective operation of our healthcare systems.Job SummaryThe Pharmacy Tech Specialist, FT Days is responsible for utilizing technical pharmacy...


  • Greenville, North Carolina, United States Physicians East Full time

    Job OverviewPhysicians East, P.A., a multi-specialty healthcare group in Eastern North Carolina, seeks an experienced Medical Coding Specialist to lead revenue optimization efforts. This role involves conducting thorough audits of coding practices, identifying areas for improvement, and ensuring compliance with industry standards.The ideal candidate will be...


  • Greenville, North Carolina, United States Vidant Health Full time

    Job SummaryVidant Health seeks a skilled Coding Specialist II to join our team. As a key member of our medical coding department, you will be responsible for reviewing and analyzing medical records to assign accurate diagnoses and procedures codes.About the RoleReview medical record documentation to extract relevant data and apply appropriate diagnosis and...


  • Greenville, South Carolina, United States Prisma Health Full time

    We are seeking a highly skilled Patient Care Specialist to join our Ambulatory Internal Resource Pool team at Prisma Health.As a Patient Care Specialist, you will play a vital role in providing exceptional patient care and support to our patients and families. This is a dynamic and rewarding position that requires strong communication and interpersonal...


  • Greenville, South Carolina, United States Prisma Health Full time

    Job SummaryWe are seeking a highly skilled Pharmacy Technician Specialist to join our team at Prisma Health. This is a non-management role that will report to a supervisor, manager, director or executive.About the RoleIn this role, you will utilize and extend your knowledge and competency while performing technical pharmacy functions of the Ambulatory...


  • Greenville, South Carolina, United States Prisma Health Full time

    About Prisma HealthAt Prisma Health, we're driven by a simple yet powerful vision: to transform healthcare for the benefits of the communities we serve. Our team is comprised of talented individuals who are passionate about delivering exceptional care and making a positive impact on people's lives.Job SummaryWe're seeking an experienced Sleep Disorder...

  • Nurse Professional

    6 days ago


    Greenville, South Carolina, United States Prisma Health Full time

    We are seeking a skilled Ambulatory Care Nurse to join our team at Prisma Health.About the RoleThis is a non-management position that will report to a supervisor, director or executive. The successful candidate will be responsible for providing routine, standardized nursing care for patients under the supervision of the physician in an ambulatory setting.Job...


  • Greenville, South Carolina, United States Chase Staffing - Greenville, SC Full time

    Job OverviewIn Greenville, SC, a large internal medicine office is seeking a skilled Medical Biller to join their team.The ideal candidate will be responsible for maximizing revenue collection by accurately and timely submitting claims, managing electronic medical records, and ensuring compliance with state and federal regulations.This role offers an...


  • Greenville, South Carolina, United States East Carolina University Full time

    East Carolina University is seeking an Identity Administrator II to join their team. This is a full-time position with a salary range of $98,020 - $108,126.About the PositionThis role will be responsible for administering and maintaining the university's identity management system. The successful candidate will have strong technical skills and experience...


  • Greenville, South Carolina, United States Johnson Controls Full time

    Electrical Systems Installation Specialist at Johnson ControlsWe are seeking an experienced Electrical Systems Installation Specialist to join our team. As a key member of our installation team, you will be responsible for installing, programming, and servicing Fire Alarm and Fire Suppression Systems.The ideal candidate will have three years of documented...


  • Greenville, South Carolina, United States Fluor Full time

    Job DescriptionAt Fluor, we strive to design and build projects that drive careers forward. Our diverse teams work together to create innovative solutions that benefit all stakeholders.This role focuses on applying fundamental design engineering principles to promote Fluor's competitiveness in the global market. As a Design Engineer II, you will support Area...


  • Greenville, South Carolina, United States SESCO Lighting Inc Full time

    Job OverviewSESCOS Lighting Inc is seeking a skilled Applications Specialist II to join our team. As a technical resource, you will provide critical support to customers and factories, troubleshooting problems in the office and field.This role requires excellent communication skills, both verbal and written, as well as the ability to multi-task and make...


  • Greenville, South Carolina, United States Prisma Health Full time

    About Prisma HealthWe are a leading healthcare organization dedicated to delivering exceptional patient care and transforming the communities we serve. Our vision is simple: to inspire health, serve with compassion, and be the difference.Salary InformationThe estimated salary for this position ranges from $65,000 to $90,000 per year, depending on experience...


  • Greenville, North Carolina, United States Palmetto Infusion Full time

    About Palmetto Infusion:Palmetto Infusion provides comprehensive ambulatory and home-based infusion services to patients with acute and chronic conditions. Our team is dedicated to delivering a warm and attentive healthcare experience that boosts patients' state-of-mind, improves their health, and quality of life.


  • Greenville, South Carolina, United States Revel Staffing Full time

    As a Piping & Utilities Engineer, you will play a key role in leading innovative projects and designing solutions for industrial manufacturing clients. With over 10 years of experience, you will have the opportunity to work with process piping systems, perform calculations, stress analysis, equipment specification, and subcontractor bid evaluations.Key...


  • Greenville, South Carolina, United States Johnson Controls Full time

    Electrical Systems Specialist - Fire Protection at Johnson ControlsThe Electrical Systems Specialist - Fire Protection is responsible for the installation, programming, and servicing of fire alarm and suppression systems. This role requires exceptional project execution skills, ensuring timely completion while delivering outstanding customer service and...


  • Greenville, North Carolina, United States The Charles Lea Center Full time

    Job OverviewWe are seeking highly motivated individuals to join our team as Empowering Independence Specialists in the Washington Region. This is a unique opportunity to make a meaningful difference in the lives of individuals with disabilities, empowering them to live more independently and achieve their goals.As an Empowering Independence Specialist, you...

  • AR Specialist

    1 week ago


    Greenville, South Carolina, United States Crossroads Treatment Center Full time

    Transform Lives in Addiction RecoveryWe are seeking an experienced Accounts Receivable Specialist to join our team at Crossroads Treatment Centers.About the RoleThe AR Specialist will play a vital role in ensuring timely and accurate payment from insurance providers for our patients receiving outpatient medication-assisted treatment. This position requires...