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Summary
The Ambulatory Coder Denials role at Prisma Health involves managing coding denials remotely. Prisma Health aims to transform healthcare, serving communities with compassion and innovation through skilled professionals dedicated to improving health outcomes.
Responsibilities
- Responsible for working coding claim denials accurately and timely in accordance with performance and productivity goals.
- Utilizes appropriate coding software and coding resources in order to determine correct codes.
- Follows departmental policies for charge corrections.
- Participates in coding educational opportunities (webinars, in house training, etc.).
- Provides timely feedback to providers or appropriate office liaison in order to clarify and resolve coding concerns.
- Submits appeals for assigned payer and/or division.
- Maintains knowledge of governmental and commercial payer guidelines.
- Assists with Compliance Team and Coding Educators to identify areas that need additional training, if applicable.
- Communicates billing related issues to assigned supervisor/manager.
- Participates in A/R Meetings in order to improve overall billing when applicable.
Requirements
- High School diploma or equivalent or post-high school diploma / highest degree earned.
- Associate degree – Preferred.
- 2 years – Professional coding or combination of coding/billing experience.
- Certified Professional Coder-CPC.
- Basic computer skills.
- Knowledge of office equipment (fax/copier).
- Proficient computer skills including word processing, spreadsheets, database and data entry.
- Mathematical skills.
