Prisma Health

The Professional Coding Auditor & Educator works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Responsibilities: Responsible for reviewing and analyzing all aspects of the department clinical documentation and care to ensure timely, accurate, and compliant charge capture and submission Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges Collaborates with Coding Supervisor to ensure clinical documentation in high-risk areas is consistent and complete Identifies inconsistencies in medical reports and works...

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

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 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 Specialist Inspire health. Serve with compassion. Be the difference. Responsible 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 purpose: 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...

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...

Inspire health. Serve with compassion. Be the difference. Job Summary Responsible 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 purpose: 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...

Prisma Health in Greenville, SC is seeking a professional to ensure the accuracy and confidentiality of patient medical records. The role involves conducting chart audits, transcription, and maintaining compliance with HIPAA regulations. The ideal candidate will have a high school diploma or equivalent, two years of relevant experience, and proficiency in EMR systems such as Epic. This position focuses on ensuring the integrity of clinical documentation in a supportive environment. #J-18808-Ljbffr

Prisma Health is seeking a Coding Specialist responsible for ensuring accurate coding for inpatient and outpatient services while adhering to compliance guidelines. The ideal candidate will validate codes based on medical documentation and resolve pre-billing edits within a supportive team environment. This position requires a High School diploma, at least two years of professional coding experience, and a Certified Professional Coder-CPC certification. Strong communication and data entry skills are essential. #J-18808-Ljbffr

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 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...

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...