Ambulatory Coding Specialist

2 days ago


Columbia, South Carolina, United States Prisma Health Full time
Job Summary

At Prisma Health, we're dedicated to transforming healthcare for the benefit of our communities. As an Ambulatory Coder Professional Billing, you'll play a vital role in our mission by abstracting and validating CPT, ICD-10, and HCPCS codes for inpatient, outpatient, and physician office/clinic settings.

Key Responsibilities
  • Validate and review codes for assigned providers/divisions based on medical record documentation, adhering to all coding and compliance guidelines (40%)
  • Resolve assigned pre-billing edits (15%)
  • Utilize coding software and resources to determine correct codes (15%)
  • Communicate billing-related issues to assigned supervisors/managers and participate in denial meetings to improve overall billing (10%)
  • Participate in coding educational opportunities, such as webinars and in-house training (5%)
  • Provide timely feedback to providers to clarify and resolve coding concerns (5%)
  • Maintain knowledge of governmental and commercial payer guidelines (5%)
  • Assist the Coding Education team in identifying areas for additional training (5%)
Requirements
  • High School diploma or equivalent, or post-high school diploma/highest degree earned (Associate degree preferred)
  • 2 years of professional coding experience
  • Certified Professional Coder (CPC) certification
Work Environment

This is a non-management role that will report to a supervisor, manager, director, or executive. The work shift is day, and the location is corporate.


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