Prisma Health

  • Greenville, SC, United States
Prisma Health
Prisma Health Greenville, SC, USA
Inspire health. Serve with compassion. Be the difference. Job Summary The Professional Billing Quality Coding Auditor will support the Medical Group Coding and Education department by performing routine reviews of coders to ensure accurate coding. This position will also perform specialty reviews as identified by Coding and Education leadership. Prepares a summary of findings and presents reports to leadership on a monthly basis. Will assist with training coders on identified opportunities for improvement. Will also assist in preventing coding denials when applicable. Accountabilities * 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. - 30% * Performs review of all coders within the department and prepares a summary of findings. - 30% * Provides training to coders on identified issues found during reviews. - 10% * Codes charges...

Prisma Health Columbia, SC, USA
Inspire health. Serve with compassion. Be the difference. Job Summary This expert level senior inpatient coder is responsible for leading coding teams, coder training, work que management, performing prebill and second-level coding reviews utilizing auditing software and documents findings to improve CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation. The coding analyst will use their knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. They will employ critical thinking skills to alert coding leadership to any trends identified in their reviews and to make suggestions for continual process improvement. The inpatient coding analyst will also review and respond to inpatient denials as needed. Performs Inpatient coding by assigning ICD-CM and ICD-PCS codes as well as DRG assignment. Accountabilities Conducts review and audit of discharged...