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Ambulatory Coder Denials, FT, Days, - Remote

Prisma Health
United States, South Carolina, Greenville
300 East McBee Avenue (Show on map)
April 28, 2024
Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for validating coding and facilitation of appeals process for all assigned denied professional service claims. All team members are expected to be knowledgeable of payer guidelines related to coding and appeal timelines. Accountabilities Responsible for working coding claim denials accurately and timely in accordance with performance and productivity goals. Utilizes appropriate coding software and coding resources in order to determine correct codes. Follows departmental policies for charge corrections. Participates in coding educational opportunities (webinars, in house training, etc.) Provides timely feedback to providers or appropriate office liasion in order to clarify and resolve coding concerns. Submits appeals for assigned payer and/or division. Maintains knowledge of governmental\u00A0 and commercial payer guidelines. Assists with Compliance Team and Coding Educators to identify areas that need additional training, if applicable. Communicates billing related issues to assigned supervisor/manager. Participates in A/R Meetings in order to improve overall billing when applicable. Minimum Education Associate\u2019s degree in related field of study or equivalent training/certification required. Minimum Experience 2 years of experience in Professional Billing Coding or Combined Coding/Billing In Lieu of the Minimum Requirements High School Diploma with 1 year coding or coding/billing experience in a professional billing setting. Licensure, Registry or Certification Required Certified Professional Coder for Professional Billing Work Shift Day (United States of America) Location Independence Pointe Facility 7001 Corporate Department 70019178 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. 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Serve with compassion. Be the difference. Job Summary Responsible for validating coding and facilitation of appeals process for all assigned denied professional service claims. All team members are expected to be knowledgeable of payer guidelines related to coding and appeal timelines. Accountabilities Responsible for working coding claim denials accurately and timely in accordance with performance and productivity goals. Utilizes appropriate coding software and coding resources in order to determine correct codes. Follows departmental policies for charge corrections. Participates in coding educational opportunities (webinars, in house training, etc.) Provides timely feedback to providers or appropriate office liasion in order to clarify and resolve coding concerns. Submits appeals for assigned payer and/or division. Maintains knowledge of governmental\u00A0 and commercial payer guidelines. Assists with Compliance Team and Coding Educators to identify areas that need additional training, if applicable. Communicates billing related issues to assigned supervisor/manager. Participates in A/R Meetings in order to improve overall billing when applicable. Minimum Education Associate\u2019s degree in related field of study or equivalent training/certification required. Minimum Experience 2 years of experience in Professional Billing Coding or Combined Coding/Billing In Lieu of the Minimum Requirements High School Diploma with 1 year coding or coding/billing experience in a professional billing setting. Licensure, Registry or Certification Required Certified Professional Coder for Professional Billing Work Shift Day (United States of America) Location Independence Pointe Facility 7001 Corporate Department 70019178 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.