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Provider Coding Educator, FT, Days, - Remote

Role overview

Qualifications

  • Bachelor's degree in Business or related field
  • Three years billing and/or coding experience
  • CPC - Certified Professional Coder
  • Knowledge of ICD-10 and CPT coding guidelines

Responsibilities

  • Educates providers and coding staff on proper coding
  • Performs random reviews of physician charges
  • Communicates billing related issues to management
  • Participates in workshops and coordinates educational sessions

Key facts

Hard skills

Other skills

  • Communication
  • Teamwork
  • Problem Solving
  • Time Management

About the company

Prisma Health logo

Prisma Health

  • Hospitals & Health Systems
  • XLarge
  • 10,001+
Prisma Health is the largest not-for-profit health organization in South Carolina, serving more than 1.2 million patients annually. The company has one Purpose: Inspire health. Serve with compassion. Be the difference. Prisma Health is comprised of two affiliates: Prisma Health–Upstate and Prisma Health– Midlands. Together they are dedicated to improving the health of all South Carolinians through improved clinical quality, access to care and patient experience, while also addressing the rising cost of health care. The affiliates are nationally recognized as some of the best places to work and to receive care. With more than 30,000 team members, physicians and volunteers, Prisma Health is the state’s largest private employer. Prisma Health works to improve the health of the local communities in the Midlands and Upstate regions through its community health programs. As one of the 50 largest health systems in the country, Prisma Health is committed to academic and clinical research excellence and focuses on educating the next generation of physicians, nurses, dentists and other medical professionals. The Prisma Health executive home office is in Greenville, South Carolina. For more information, visit www.prismahealth.org. ALERT: We will never request personal information and/or money in exchange for an interview and we do not conduct interviews via Google Meet or Google Chat. There have been reports of malicious people posing as Prisma Health hiring managers and conducting interviews with candidates via Google Meet or Google Chat. This is a phishing scam that could result in them taking your identity and/or money. Our hiring managers and recruiters do not conduct interviews via Google Meet or Google Chat. If you are contacted by someone claiming to be a Prisma Health team member, and they ask you to interview via a Google app, end communication immediately and report the action to the police.

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Job description

Inspire health. Serve with compassion. Be the difference.

Job Summary

Ensures all provider services are completely and accurately coded according to approved coding guidelines. Provides coding support to the providers and staff by performing periodic coding reviews, conducting various coding education and training sessions.

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.
  • Educates providers and coding staff within the physician practice setting on proper CPT, ICD-10 and HCPCS coding. Performs random reviews of physician charges to identify opportunities for charge capture, ICD-10 specificity and proper coding of all services rendered. 
  • Reviews and responds to coding questions submitted by physicians and coding staff within a timely manner.
  • Communicates billing related issues to assigned supervisor/manager.
  • Shadows provider and coding staff to confirm coding is supported by medical record documentation and identify opportunities to improve upon documentation and coding.
  • Participates in workshops, seminars, webinars, and other educational opportunities to ensure continued learning. Maintain current certification(s) and working knowledge if ICD-10 and CPT coding guidelines.
  • Recommends changes to billing procedures to achieve compliance with applicable laws, rules and regulations.
  • Obtains and maintains instructor status for AAPC PMCC Coding Curriculum, if applicable. Coordinates class schedule and provides instruction for the PMCC Coding Curriculum offered by the AAPC, if applicable.
  • Maintains knowledge if state and federal regulatory guidelines related to proper coding.
  • Participates in meetings with Corporate Compliance in order to identify opportunities for improvement.  Schedules education sessions with providers to provide education based on audit findings, if applicable.
  • Participates in A/R Meetings in order to improve overall coding when applicable.
  • Performs other duties as assigned.

Supervisory/Management Responsibilities

  • This is a non-management job that will report to a supervisor, manager, director or executive.

Minimum Requirements

  • Education - Bachelor's degree in Business or related field of study
  • Experience - Three (3) years billing and/or coding experience

In Lieu Of

  • Associate degree with 5 years of coding or coding/billing experience in a professional billing setting. High School Diploma with 7 years coding or coding/billing experience in a professional billing setting.

Required Certifications, Registrations, Licenses

  • CPC - CERT PROFESSIONAL CODER
     

Knowledge, Skills and Abilities

  • Data entry skills

Work Shift

Day (United States of America)

Location

Independence Pointe

Facility

Corporate

Department

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.

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