Prisma Health

• Responsible for monitoring and/or resolution of high dollar, high profile, escalated accounts • Ensures timely and accurate posting, adjustments, correspondence, and/or denials • Supports various special projects ensuring billing, AR, and denial prevention are optimal • Monitors, research and/or resolves high dollar, high profile, and problem accounts • Identifies trends and works with other departments to resolve system issues • Evaluates payer performance and payment trends • Assures timely communication of all meeting outcomes to appropriate PFS team members • Maintains professional growth and development through seminars, workshops, and in-service meetings • Responsible and accountable for reconciliation and accuracy of vendor invoices

Title: Health Information Management Inpatient Coder Location: Columbia United States Job Description: Inspire health. Serve with compassion. Be the difference. Job Summary Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Essential Functions - All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. - Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Performs Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of Diseases-Procedure Coding System (ICD-PCS) codes as well as the Diagnosis Related Groups (DRG) assignment. Abstracts and assigns and verifies codes for Major Complications and Comorbidities/Complications and Comorbidities (MCC/CCs), Hospital-Acquired Condition/Patient Safety Indicator (HAC/PSI) and Quality Indicators capture as appropriate through documentation validation. - Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Incumbent(s) operate under the general supervision of HIM Coding leadership. - Applies ICD and ICD-PCS codes to inpatient records, including major traumas, and Neonatal Intensive Care Unit (NICU) records based on review of clinical documentation. Verifies assignment of DRGs, MCC/CCs, Hospital Acquired Conditions (HACs) and Patient Safety Indicators (PSIs) that most appropriately reflect documentation of the occurrence of events, severity of illness, and resources utilized during the inpatient encounter and in compliance with department policies and procedures. Selects the optimal principal diagnoses with appropriate POA indicator assignment and sequencing of risk adjustment diagnoses following established guidelines. - Reviews work queues to identify charts that need to be coded and prioritizes as per department-specific guidelines and within designated timelines. Follows up on On-hold accounts daily for final coding. - Identifies and requests physician queries following established guidelines when existing documentation is unclear or ambiguous following American Health Information Management (AHIMA) guidelines and established organization policies. Ensures all open queries initiated by Clinical Documentation Specialists have been addressed prior to final coding. - Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Adheres to department standards for productivity and accuracy. Identifies and trends coding issues escalating identified concerns - Consults, provides professional expertise to and collaborates with clinical documentation specialists on coding and documentation practices and standards. - Performs other duties as assigned. Supervisory/Management Responsibilities - This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements - Education - Certification Program or Associate degree or Coding Certificate through American Health Information Management (AHIMA) or other approved coding certification program. - Experience - Three (3) years coding experience in an acute care or ambulatory setting. Inpatient coding experience. EPIC health information system experiences preferred. In Lieu Of - In lieu of education and experience requirements noted above, successful completion of the IP Coder Associate program or coder associate may be considered. Required Certifications, Registrations, Licenses - Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC) or other approved coding credential. Knowledge, Skills and Abilities - Participates in on site, remote and/or external training workshops and training. Attends and participates in CDI-Coding Task Force and other collaborative training and education with CDI, PFS and Quality. - Demonstrates proficiency in utilizing official coding books as well as the electronic medical record, computer assisted coding/encoding software, and clinical documentation information systems to facilitate coding assignment. - Knowledge of electronic medical records and 3M or Encoder System. - Knowledge of medical terminology and basic anatomy and physiology, pathophysiology, and pharmacology with the ability to apply this knowledge to the coding process. - Knowledge of MS DRG prospective payment system and severity systems. - Ability to concentrate for extended periods of time. - Ability to work and make decisions independently. Work Shift Day (United States of America) Location 5 Medical Park Rd Richland Facility 1500 Midlands Corporate Department 70017512 HIM-Coding

• Configures programs, screens pathways, reports and/or job instructions to meet detailed user specifications • Supports Information Systems Analysts in providing technical assistance to customer departments • Maintains databases for one or more applications supported by the team • Works with assigned departments to prioritize development initiatives and activities • Maintains system hardware and/or software for one or more of the supported applications • Provides analysis of workflow, recommends solutions, and implements application solutions to meet departmental needs • Coordinates and resolves system problems related to technology used by assigned systems • Supports internal customers as assigned • Assists in managing system upgrades and other small projects

• Responsible for abstracting and validating CPT, ICD-10 and HCPCS codes • Adheres to all coding and compliance guidelines • Maintains knowledge of coding/billing updates and payer specific coding guidelines • Communicates billing related issues to assigned supervisor/manager • Participates in coding educational opportunities • Provides feedback to providers to clarify and resolve coding concerns • Resolves assigned pre-billing edits • Assists in identifying areas that require additional training • Mentors and assists in training other coders and new team members

• Provides analysis of workflow, recommend solutions and implements application solutions to meet department needs. • Translates department requirements into business functional requirements. • Performs a variety of duties related to Epic and other information technology applications as assigned. • Assisting with design, development, system configuration, implementation and support of assigned Epic applications for the organization. • Responsible for planning, training and evaluation of application functionality. • Responsible for working with the team and key customers to ensure appropriate development of training and implementation of application functionality.

• Responsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings. • Adheres to all coding and compliance guidelines. • Maintains knowledge of coding/billing updates and payer specific coding guidelines. • Serves as a subject matter expert for assigned specialty. • Abstracts/codes for assigned provider(s)/division(s) based on medical record documentation. • Utilizes appropriate coding software and coding resources in order to determine correct codes. • Communicates billing related issues to assigned supervisor/manager and participates in meetings in order to improve overall billing, when applicable. • Follows departmental policies for charge corrections. • Participates in coding educational opportunities (webinars, in house training, etc.). • Provides feedback to providers in order to clarify and resolve coding concerns. • Resolves assigned pre-billing edits. • Assists in identifying areas that require additional training. • Mentors and assists in training other coders and new team members.

• Responsible for validating/reviewing and assigning applicable CPT, ICD-10, Modifiers and HCPCS codes for inpatient, outpatient and physicians office/clinic settings. • Adheres to all coding and compliance guidelines. • Maintains knowledge of coding/billing updates and payer specific coding guidelines for multi-specialty medical practice(s). • Communicates with providers and team members regarding coding issues.

Role Description Responsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines. Serves as a subject matter expert for assigned specialty. - All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. - Abstracts/codes for assigned provider(s)/division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. - Utilizes appropriate coding software and coding resources in order to determine correct codes. - Communicates billing related issues to assigned supervisor/manager and participates in meetings in order to improve overall billing, when applicable. - Follows departmental policies for charge corrections. - Participates in coding educational opportunities (webinars, in house training, etc.). - Provides feedback to providers in order to clarify and resolve coding concerns. - Resolves assigned pre-billing edits. - Assists in identifying areas that require additional training. - Mentors and assists in training other coders and new team members. - Performs other duties as assigned. Qualifications - Education - High School diploma or equivalent or post-high school diploma / highest degree earned. - Associate degree preferred. - Experience - Five (5) years professional fee coding experience. Requirements - Certified Professional Coder (CPC). - Specialty Certification from AAPC that correlates with assigned specialty. Knowledge, Skills and Abilities - Maintain knowledge of governmental and commercial payer guidelines. - Knowledge of office equipment (fax/copier). - Proficient computer skills including word processing, spreadsheets, database. - Data entry skills. - Mathematical skills. Work Shift Day (United States of America) Location Independence Pointe Facility 7001 Corporate Department 70019178 Medical Group Coding & Education Services

Role Description Performs tasks of moderate to difficult complexity relating to physician and hospital accounts. Responsible for data analysis and interpretation throughout all functions of revenue cycle, analysis of aged accounts including remittances to determine reasons for denials, non-payment and overpayment, post/balance/correct electronic remittances, billing and follow-up of government payers and specialized accounts, analysis/correction of correct coding guidelines, preparation of accounts for appeal, review/analysis of insurance credit balances and/or patient credits to include analysis/movement of unapplied, unidentified, undistributed balances. Moderate to difficult levels of evaluation, analysis, decision making required in these roles. - All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. - Analyzes insurance and/or patient credit balances to determine root cause, takes action to resolve account. - Contacts payer and makes hard inquiries on account status. Escalates problem account. - Documents billing activity on the patient accounts according to departmental guidelines; ensures compliance with all applicable billing regulations and reports any suspected compliance issues to departmental leaders. - Properly documents accounts clearly with indicators and activities so that tracking and trending can be prepared for further analysis. - Ensures all work is compliant with privacy, HIPAA, and regulatory requirements. - Participates in general or special assignments and attends all required training. - Adheres to policies and procedures as required by Prisma Health and follows all compliant regulatory payer guidance. - Performs other duties as assigned. Qualifications - Education - High School diploma or equivalent OR post-high school diploma / highest degree earned - Experience - Two (2) years billing, bookkeeping, accounting experience Requirements - Knowledgeable of the job functions required for a Denial/Appeals Specialist, Payment Research Specialist and a Quality Assurance Specialist. Work Shift - Day (United States of America) Location - Colonial Life Building Facility - 7001 Corporate Department - 70019935 System Billing Office Company Description Share 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.

• Responsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings • Adheres to all coding and compliance guidelines • Maintains knowledge of coding/billing updates and payer specific coding guidelines • Serves as a subject matter expert for assigned specialty • Communicates billing related issues to assigned supervisor/manager • Participates in coding educational opportunities (webinars, in house training, etc.) • Provides feedback to providers in order to clarify and resolve coding concerns • Resolves assigned pre-billing edits • Assists in identifying areas that require additional training • Mentors and assists in training other coders and new team members