Description
Inspire health. Serve with compassion. Be the difference.
Job Summary
Implements and coordinates the UMG Coding and Education Program to include quality training meeting established standards of Prisma Health and University Medical Group (UMG). Coordinates the coding and educational services between the UMG Administration, Departmental Operation Leadership, UMG MSO, Physician Practices and the Compliance Office.Accountabilities
- Coordinates Coding and Educational Services for Physicians and Non-physicians, and participates in the efforts of the Prisma Health Quality Coding Assurance Program review and audit process. Includes coordinating coding and educational activities of employees, review of discrepancies, and audit of Managed Care payors related to coding. Develops coding and training material for quality and coding staff to use in practice and physician meetings and review of training material annually to ensure accuracy. Informs manager of substandard provider proficiency scores. Develop positive customer relationships by anticipating and providing solutions to the needs of the various physicians, practices, and departments within UMG.
- Works with Director, Coding and Educational Services to maintain current data on coding regulations impacting facility, physician practices and ancillary services, including review of the various price files and billing systems for the appropriate coding information.
- Coordinates and facilitates the coding communication of Physician leadership, including physician meetings, training sessions and staff education.
- Acts as liaison between UMG and various Federal and third party payors regarding coding issues and payor audits.
- Develops and coordinates coding education for existing coders within UMG and ensures that all coders continue with CME for required job certifications.
- Coordinates and evaluates the procurement of coding resources for UMG.
- Works with Corporate Compliance, Internal Audit and UMG Denials as required.
Supervisory/Management Responsibility
This is a non-management job that will report to a supervisor, manager, director, or executive.
Minimum Requirements
- Bachelor's Degree in Business Administration, Accounting/finance or healthcare-related field.
- 6 years of experience: 2 years in CPT, ICD-10 and HCPCS coding AND 2 years in auditing and coding compliance AND 2 years in training, lead, supervisory, or management in healthcare billing or coding.
Required Certifications/Registrations/Licenses
CPC - CERT PROFESSIONAL CODER - C034
In Lieu Of The Above Minimum Requirements
An additional 4 years of any combination of the experience listed above may substitute for the Minimum Education listed above.
Other Required Skills and Experience
PowerPoint - Preferred
Work Shift
Day (United States of America)Location
1200 Colonial Life BlvdFacility
7001 CorporateDepartment
70019178 Medical Group Coding & Education ServicesShare your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
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