Ambulatory Coder III, Cardio
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Job Description
Ambulatory coder validating CPT, ICD-10, and HCPCS codes for Prisma Health. Supporting specialty billing compliance, provider clarification, pre-billing edits, and coder training.
Responsibilities:
- Abstract and validate CPT, ICD-10, and HCPCS codes for inpatient, outpatient, and physician's office/clinic settings
- Adhere to coding and compliance guidelines
- Maintain knowledge of coding/billing updates and payer-specific coding guidelines
- Serve as a subject matter expert for the assigned specialty
- Code assigned providers/divisions based on medical record documentation
- Use coding software and coding resources to determine correct codes
- Communicate billing-related issues to the assigned supervisor/manager and participate in improvement meetings
- Follow departmental policies for charge corrections
- Participate in coding education opportunities, including webinars and in-house training
- Provide provider feedback to clarify and resolve coding concerns
- Resolve assigned pre-billing edits
- Identify areas requiring additional training
- Mentor and assist in training other coders and new team members
- Perform other duties as assigned
Requirements:
- High School diploma or equivalent or post-high school diploma / highest degree earned
- Five (5) years professional fee coding experience
- Certified Professional Coder (CPC)
- Specialty Certification from AAPC correlating with the assigned specialty
- Knowledge of governmental and commercial payer guidelines
- Knowledge of office equipment, including fax/copier
- Proficient computer skills, including word processing, spreadsheets, and databases
- Data entry skills
- Mathematical skills
- Knowledge of and compliance with Prisma Health's purpose and coding/compliance guidelines
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