Prisma Health

Medical Coder Inspire health. Serve with compassion. Be the difference. Job Summary Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Performs Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of...

Coding Specialist Inspire health. Serve with compassion. Be the difference. Responsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines. Serves as a subject matter expert for assigned specialty. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Abstracts/codes for assigned provider(s)/division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. Utilizes appropriate coding software and coding resources in order to determine correct codes. Communicates billing related issues to assigned supervisor/manager and participates in meetings in order to improve overall billing, when applicable. Follows departmental...

Coding Specialist Inspire health. Serve with compassion. Be the difference. Responsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines. Serves as a subject matter expert for assigned specialty. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Abstracts/codes for assigned provider(s)/division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. Utilizes appropriate coding software and coding resources in order to determine correct codes. Communicates billing related issues to assigned supervisor/manager and participates in meetings in order to improve overall billing, when applicable. Follows departmental...

Prisma Health in South Carolina is seeking a Hospital Billing Specialist to accurately submit claims and follow up on aged and high-dollar accounts in accordance with payer guidelines. You will coordinate with departments to resolve denials, verify payments, and ensure postings are correct. Strong communication and attention to detail are essential to maintain AR levels and support patient financial services. #J-18808-Ljbffr

Job Summary Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Performs Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of Diseases-Procedure Coding System (ICD-PCS) codes as well as the Diagnosis Related...

Coding SpecialistInspire health. Serve with compassion. Be the difference.Responsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines. Serves as a subject matter expert for assigned specialty.Essential FunctionsAll team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference.Abstracts/codes for assigned provider(s)/division(s) based on medical record documentation. Adheres to all coding and compliance guidelines.Utilizes appropriate coding software and coding resources in order to determine correct codes.Communicates billing related issues to assigned supervisor/manager and participates in meetings in order to improve overall billing, when applicable.Follows departmental policies for charge...

Job Summary Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Performs Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of Diseases-Procedure Coding System (ICD-PCS) codes as well as the Diagnosis Related...

Prisma Health in Columbia, SC is seeking a medical coder responsible for coding medical information using established guidelines. Candidates should have three years of coding experience in acute care or ambulatory settings and relevant certifications. The role involves coding for multiple facilities and adhering to Prisma Health's policies for accuracy and compliance. Work will be performed during the day shift. #J-18808-Ljbffr

Prisma Health is seeking a qualified medical coder for the Greenville location. This role focuses on abstracting and validating CPT, ICD-10, and HCPCS codes for various healthcare settings while adhering to compliance guidelines and updates. Candidates should have at least 5 years of professional coding experience and hold a Certified Professional Coder certification. Additional qualifications include teamwork and mentoring skills, proficiency in coding software, and the ability to communicate effectively. Join us to inspire health, serve with compassion, and be the difference. #J-18808-Ljbffr

Coding SpecialistInspire health. Serve with compassion. Be the difference.Performs routine and specialty reviews of coders to ensure accurate coding. Prepares a summary of findings and presents reports to leadership on a monthly basis. Assists with training coders on identified opportunities for improvement. Assists in preventing coding denials.Essential FunctionsAll team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference.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...

Follows departmental policies for charge corrections. Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines. Serves as a subject matter expert for assigned specialty. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Abstracts/codes for assigned provider(s)/division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. Utilizes appropriate coding software and coding resources in order to determine correct codes. Communicates billing related issues to assigned supervisor/manager and participates in meetings in order to improve overall...

Job TitleInspire health. Serve with compassion. Be the difference.Job SummaryConducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission.Essential FunctionsAll team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference.Conducts prospective review of charts to identify HCC opportunity.Conducts retrospective review of charts to confirm documentation supports reporting.Utilizes payor specific software to assist in capturing HCCs.Communicates with providers about HCC opportunities for improvement.Identifies suspect conditions that would potentially support reporting an HCC.Participates in education...

Job Title Inspire health. Serve with compassion. Be the difference. Job Summary Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Conducts prospective review of charts to identify HCC opportunity. Conducts retrospective review of charts to confirm documentation supports reporting. Utilizes payor specific software to assist in capturing HCCs. Communicates with providers about HCC opportunities for improvement. Identifies suspect conditions that would potentially support reporting an...

Inspire health. Serve with compassion. Be the difference. Job Summary Performs routine and specialty reviews of coders to ensure accurate coding. Prepares a summary of findings and presents reports to leadership on a monthly basis. Assists with training coders on identified opportunities for improvement. Assists in preventing coding denials. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. 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...

Inspire health. Serve with compassion. Be the difference. Job Summary Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Conducts prospective review of charts to identify HCC opportunity. Conducts retrospective review of charts to confirm documentation supports reporting. Utilizes payor specific software to assist in capturing HCCs. Communicates with providers about HCC opportunities for improvement. Identifies suspect conditions that would potentially support reporting an HCC....

Medical Coder Inspire health. Serve with compassion. Be the difference. Job Summary Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Performs Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of...

Inspire health.Serve with compassion.Be the difference.Job SummaryResponsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office / clinic settings.Adheres to all coding and compliance guidelines.Maintains knowledge of coding / billing updates and payer specific coding guidelines.Serves as a subject matter expert for assigned specialty.Essential FunctionsAll team members are expected to be knowledgeable and compliant with Prisma Health's values :Inspire health.Serve with compassion.Be the difference.Abstracts / codes for assigned provider(s) / division(s) based on medical record documentation.Adheres to all coding and compliance guidelines.Utilizes appropriate coding software and coding resources in order to determine correct codes.Communicates billing related issues to assigned supervisor / manager and participates in meetings in order to improve overall billing, when applicable.Follows departmental policies for charge...

Inspire health.Serve with compassion.Be the difference.Job SummaryResponsible for validating/reviewing and assigning applicable CPT, ICD-10, Modifiers and HCPCS codes for inpatient, outpatient and physicians office/clinic settings.Adheres to all coding and compliance guidelines.Maintains knowledge of coding/billing updates and payer specific coding guidelines for multi-specialty medical practice(s).Communicates with providers and team members regarding coding issues.Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values:Inspire health.Serve with compassion.Be the difference. Validates/reviews codes for assigned provider(s)/Division(s) based on medical record documentation.Adheres to all coding and compliance guidelines. Responsible for resolving all assigned pre-billing edits Communicates billing related issues and participates in meetings to improve overall billing process Provides feedback to providers in order to clarify...

Inspire health.Serve with compassion.Be the difference.Job SummaryResponsible for validating / reviewing and assigning applicable CPT, ICD-10, Modifiers and HCPCS codes for inpatient, outpatient and physicians office / clinic settings.Adheres to all coding and compliance guidelines.Maintains knowledge of coding / billing updates and payer specific coding guidelines for multi-specialty medical practice(s).Communicates with providers and team members regarding coding issues.Essential FunctionsAll team members are expected to be knowledgeable and compliant with Prisma Health's values :Inspire health.Serve with compassion.Be the difference.Validates / reviews codes for assigned provider(s) / Division(s) based on medical record documentation.Adheres to all coding and compliance guidelines.Responsible for resolving all assigned pre-billing editsCommunicates billing related issues and participates in meetings to improve overall billing processProvides feedback to providers in order to...

Inspire health.Serve with compassion.Be the difference.Job SummaryResponsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office / clinic settings.Adheres to all coding and compliance guidelines.Maintains knowledge of coding / billing updates and payer specific coding guidelines.Serves as a subject matter expert for assigned specialty.Essential FunctionsAll team members are expected to be knowledgeable and compliant with Prisma Health's values :Inspire health.Serve with compassion.Be the difference.Abstracts / codes for assigned provider(s) / division(s) based on medical record documentation.Adheres to all coding and compliance guidelines.Utilizes appropriate coding software and coding resources in order to determine correct codes.Communicates billing related issues to assigned supervisor / manager and participates in meetings in order to improve overall billing, when applicable.Follows departmental policies for charge...

Inspire health.Serve with compassion.Be the difference.Job SummaryResponsible for validating / reviewing front end coding edits and assigning applicable CPT, ICD-10, Modifiers and HCPCS codes for inpatient, outpatient and physicians office / clinic settings.Adheres to all coding and compliance guidelines.Maintains knowledge of coding / billing updates and payer specific coding guidelines for multi-specialty medical practice(s).Communicates with providers and team members regarding coding issues.Essential FunctionsAll team members are expected to be knowledgeable and compliant with Prisma Health's values :Inspire health.Serve with compassion.Be the difference.Validates / reviews codes for assigned provider(s) / Division(s) based on medical record documentation.Adheres to all coding and compliance guidelines.Utilizes appropriate coding software and coding resources in order to determine correct codes.Responsible for resolving all assigned pre-billing edits.Communicates billing...

Inspire health.Serve with compassion.Be the difference.Job SummaryResponsible 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.Communicates with providers regarding coding denial issues.Ensures documentation supports CPT, Modifiers, HCPCS and ICD-10 codes for submitted appeals, reopenings, reconsiderations, etc.Essential FunctionsAll team members are expected to be knowledgeable and compliant with Prisma Health's values :Inspire health.Serve with compassion.Be the difference.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.Communicates billing related issuesFollows departmental policies for charge corrections.Participates in coding educational...

Inspire health.Serve with compassion.Be the difference.Job SummaryCodes medical information into the organization billing / abstracting systems for multiple facilities.Performs moderate to complex Outpatient Surgery, Gastrointestinal (GI) Procedure and Observation coding by assigning International Classification of Diseases (ICD), Current Procedural Terminology (CPT) codes, and HCC codes.Performs Emergency Department, ambulatory clinic, diagnostic, and ancillary coding.Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes.Essential FunctionsAll team members are expected to be knowledgeable and compliant with Prisma Health's values :Inspire health.Serve with compassion.Be the difference.Codes moderate to complex Outpatient Surgery, and Observation records from clinical documentation as well as Emergency department, ancillary and ambulatory clinic records; assigns modifiers as appropriate.Queries...