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Professional Billing Quality Coding Auditor

Prisma Health

Performs routine and specialty reviews of coders to ensure accurate coding. Prepares monthly summary reports of findings for leadership. Assists with training coders on identified opportunities for improvement and helps prevent coding denials.

Performs multi-specialty reviews for the Medical Group validating CPT, ICD-10, modifiers, and HCPCS codes using official coding guidelines and CMS guidelines. Reviews coders within the department, identifies coding issues, supports process improvement, and helps create edits and standardized front-end coding processes. Mentors and trains coders, collaborates with other departments to resolve coding issues, and performs other duties as assigned.

Requirements & Qualifications
  • Bachelor's degree in Business or a related field
  • 3 years of multi-specialty coding experience in professional billing
  • CPC certification (AAPC)
  • CPMA certification (AAPC)
  • Knowledge of medical terminology, basic anatomy, and physiology
  • Ability to apply coding concepts to ensure correct coding
  • Strong analytical skills
  • Working knowledge of Epic, Encoder Pro, and 3M
  • Ability to work independently and manage multiple projects
  • Proficient computer skills, including word processing, spreadsheets, and databases
  • Data entry skills

Location

South Carolina, US

Employment Type

Full-time

Experience Level

Intermediate Level

Remote work allowed

Yes

Posted

2 weeks ago

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