Ambulatory Coder Denials III
Prisma Health
full-time
Posted on:
Location Type: Remote
Location: South Carolina • United States
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About the role
- Responsible for validating coding and facilitation of appeals process for all assigned denied professional service claims
- Communicates with providers regarding coding denial issues
- Ensures documentation supports CPT, Modifiers, HCPCS and ICD-10 codes for submitted appeals
- Serves as a subject matter expert for assigned specialty
- Communicates with team members regarding coding denial issues and trends
- Responsible for working coding claim denials accurately and timely in accordance with performance and productivity goals
- Follows departmental policies for charge corrections
- Provides feedback to providers or appropriate office liaison in order to clarify and resolve coding concerns
- Submits appeals for assigned payer and/or division
Requirements
- High School Diploma or equivalent
- Five (5) years professional coding and/or billing experience
- Certified Professional Coder -CPC
- CPMA or Specialty Coding Certification for assigned specialty
- Knowledge of governmental and commercial payer guidelines
- Proficient computer skills including word processing, spreadsheets, database
- Data entry skills
- Mathematical skills
Benefits
- Inspire health
- Serve with compassion
- Be the difference
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
codingbillingCPT codesModifiersHCPCS codesICD-10 codesdata entrymathematical skills
Soft Skills
communicationfeedbackteam collaboration
Certifications
Certified Professional Coder - CPCCPMASpecialty Coding Certification