Professional Billing Quality Coding Auditor
Are you passionate about maintaining high-quality standards in medical billing and coding? Prisma Health is seeking a detail-oriented and experienced Professional Billing Quality Coding Auditor to join our team. As a crucial member of our Revenue Cycle team, you will be responsible for conducting comprehensive audits to ensure accurate and compliant coding of medical records. This is a unique opportunity to make a significant impact on the financial health of our organization while also promoting patient satisfaction. If you possess the necessary qualifications and have a strong attention to detail, we invite you to apply for this exciting position.
- Conduct comprehensive audits of medical records to ensure accurate and compliant coding.
- Review and analyze coding documentation to identify any discrepancies or errors.
- Communicate audit findings to relevant team members and provide recommendations for improvement.
- Keep up-to-date with coding guidelines and regulations to ensure compliance.
- Collaborate with other departments to resolve coding and billing issues.
- Train and educate coding and billing staff on proper coding practices and regulations.
- Monitor coding and billing processes to identify areas for improvement and implement solutions.
- Maintain accurate and detailed records of audit findings and corrective actions taken.
- Identify potential areas of fraud and abuse and report any suspicious activities.
- Act as a resource for team members regarding coding and billing inquiries.
- Stay informed about changes in coding and billing regulations and update policies and procedures accordingly.
- Ensure that all coding and billing practices are in line with company policies and procedures.
- Participate in coding and billing compliance audits conducted by external agencies.
- Collaborate with healthcare providers to ensure accurate and timely documentation and coding.
- Promote a culture of continuous improvement and quality in coding and billing practices.
Extensive Knowledge Of Medical Coding: Applicants Should Have A Strong Understanding Of Medical Coding Systems, Including Icd-10, Cpt, And Hcpcs. This Knowledge Is Crucial For Accurately Reviewing And Auditing Medical Claims.
Certification In Coding Or Auditing: A Professional Billing Quality Coding Auditor Should Hold A Coding Or Auditing Certification From A Recognized Organization Such As Aapc Or Ahima. This Demonstrates A High Level Of Expertise And Understanding Of Coding Regulations And Guidelines.
Experience In Billing And Coding Auditing: Prisma Health Expects Applicants To Have At Least 3-5 Years Of Experience In Medical Coding And Billing Auditing. This Experience Should Include Conducting Coding Audits, Identifying Errors, And Providing Feedback To Improve Coding Accuracy.
Attention To Detail: A Successful Coding Auditor Must Have A Keen Eye For Detail And Be Able To Identify Coding Errors And Discrepancies. They Should Be Able To Review Large Amounts Of Data And Identify Patterns Or Trends That Require Further Investigation.
Strong Communication Skills: As A Coding Auditor, The Ability To Effectively Communicate And Provide Feedback To Healthcare Providers And Billing Staff Is Essential. Applicants Should Have Strong Written And Verbal Communication Skills To Clearly Explain Audit Findings And Recommendations For Improvement.
Data Analysis
Revenue cycle management
Medical coding
Documentation review
Payment reconciliation
Compliance Standards
Audit Procedures
Cpt
Coding Accuracy
Icd-10 Coding
Billing Guidelines
Communication
Conflict Resolution
Emotional Intelligence
Leadership
Time management
creativity
Critical thinking
Teamwork
Adaptability
Problem-Solving
According to JobzMall, the average salary range for a Professional Billing Quality Coding Auditor in Greenville, SC, USA is between $52,000 and $76,000 per year. This range may vary depending on factors such as years of experience, education level, and specific job responsibilities within the role.
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Prisma Health is the largest not-for-profit health organization in South Carolina, serving more than 1.2 million patients annually. 32,000 team members are dedicated to supporting the health and well-being of people.
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