Prisma Health

Nurse

• Coordinate an interdisciplinary plan of care or program for a specific patient population
• Function as a clinical, patient, and community resource, educator, and consultant
• Participate in direct and indirect patient care, patient rounds, consultation, multidisciplinary care planning, and evaluation
• Collaborate with health team members to develop, implement, and evaluate cost-effective quality programs
• Develop, provide, and evaluate educational programs for patients, families, staff, and the community
• Monitor and ensure accurate patient-record documentation
• Maintain required reports, records, and program statistics
• Monitor care quality, identify issues, and integrate process improvement into practice
• Participate in research/investigative studies when indicated
• Perform other duties as assigned

Registered Nurse, Program Coordinator, Pharmacy Nurse Controlled Substance Diversion Investigator

Patient Access Specialist

• Receive and interview patients to collect and verify demographic and financial data
• Verify insurance and initiate pre-authorization processes when required
• Collect required payments or make necessary financial arrangements
• Enter accurate information into computer databases and access Sovera for insurance-card verification
• Scan documents and follow up on incomplete or missing information
• Document insurance verification information and assign appropriate insurance plans
• Obtain signatures and information on required forms and documents
• Receive payments, issue receipts, maintain cash funds and verification logs, and make daily deposits
• Prepare and distribute reports, documents, patient identification items, and patient information materials
• Communicate estimated financial responsibility and request payment before or at the time of service
• Refer patients to payment-program or financial-assistance resources when appropriate
• Report to a supervisor, manager, director, or executive in a non-management role

Auditor

• Lead coding teams
• Train and mentor coders on correct ICD-CM and ICD-PCS guideline application
• Manage work queues daily, prioritizing and assigning inpatient accounts for coding within designated timelines
• Conduct prebill and retrospective audits of discharged inpatient records to validate coding and DRG assignments
• Document audit findings to improve CC/MCC capture, risk variable capture, HAC/PSI, HCC, and quality indicator validation
• Identify documentation, coding, reimbursement, and coding compliance issues and report trends to coding leadership
• Coordinate provider documentation queries for the Clinical Documentation Integrity team
• Consult and collaborate with clinical documentation specialists on coding and documentation practices
• Develop and maintain coding curriculum and training materials
• Develop educational programs for coding, clinical documentation, and medical staff, including yearly coding/DRG updates
• Assign ICD and ICD-PCS codes and DRGs for inpatient records, including major traumas and NICU records
• Verify DRGs, MCCs/CCs, HACs, and PSIs; select principal diagnoses and assign POA indicators and risk-adjustment diagnoses
• Review and respond to inpatient denials and assist with coding and clinical validation denials
• Assist management with coding issue resolution, process improvement, and HIM application system testing
• Participate in CDI-Coding Task Force and collaborative training with CDI, PFS, specialty areas, and Quality
• Perform other duties as assigned

Senior Health Information Management Inpatient Coding Auditor

General

• Abstract and validate CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings
• Abstract and code for assigned providers/divisions based on medical record documentation
• 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
• Utilize coding software and coding resources to determine correct codes
• Communicate billing-related issues to the assigned supervisor/manager
• Participate in meetings to improve overall billing
• Follow departmental policies for charge corrections
• Provide feedback to providers 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

Ambulatory Coder III

Analyst

• Advise departmental revenue owners and staff on proper usage of charge codes using medical record analysis
• Review and apply billing guidelines, state and federal regulations, and third-party billing rules and coverage
• Identify opportunities to capture additional revenue in accordance with applicable guidelines
• Monitor daily charge capture, revenue reconciliation, late charge trending, revenue trending, and work queues
• Identify operational trends and benchmarks
• Work with Revenue Cycle and IT staff to resolve accounts not routing through the HB Revenue Cycle process
• Validate principal and secondary diagnoses, procedures, and CPT/HCPCS codes
• Develop data requirements and work with analytics groups on internal charge review audits
• Assist the supervisor with coding and billing questions, escalated accounts, and issues
• Participate in system conversions, implementations, upgrades, Epic go-live charging hub activities, and the Revenue Management Task Force
• Provide coding and reimbursement revenue review for proposed system builds
• Work with CDM, clinical departments, and I/S to support Epic and system build for charge entry and capture
• Identify and troubleshoot charge issues and enhancement opportunities
• Optimize processes so services are accurately reported and reimbursed while maintaining compliance
• Review departmental charge capture processes and update documented procedures
• Coordinate with department leadership, CDM team, and stakeholders on new procedures, charge setup, and education
• Partner with vendors on optimization projects involving data review, auditing, and testing
• Perform other duties as assigned

Senior Charge Capture Analyst

Medical Billing and Coding

• Validate/review and assign applicable CPT, ICD-10, Modifiers and HCPCS codes for inpatient, outpatient and physicians office/clinic settings
• Adhere to coding and compliance guidelines
• Maintain knowledge of coding/billing updates and payer-specific coding guidelines for multi-specialty medical practices
• Resolve assigned pre-billing edits
• Communicate billing-related issues and participate in meetings to improve the overall billing process
• Provide feedback to providers to clarify and resolve coding concerns
• Assist in identifying areas needing additional training
• Perform other duties as assigned

Ambulatory Coder II – Professional Billing

• Abstract and validate CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings
• Adhere to all 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
• Abstract/code for assigned providers/divisions based on medical record documentation
• Use appropriate coding software and coding resources to determine correct codes
• Communicate billing-related issues to the assigned supervisor/manager and participate in meetings to improve overall billing
• Follow departmental policies for charge corrections
• Participate in coding educational opportunities, including webinars and in-house training
• Provide feedback to providers to clarify and resolve coding concerns
• Resolve assigned pre-billing edits
• Assist in identifying areas requiring additional training
• Mentor and assist in training other coders and new team members
• Perform other duties as assigned

Ambulatory Coder III, Orthopedics

• Analyze workflows, data collection, report details, and technical issues associated with Epic software
• Investigate end-user preferences and analyze business operations to inform build decisions
• Build and maintain Epic application content
• Follow functional specifications to create Epic application content
• Complete unit testing and support functional and integrated testing
• Document and report system issues and communicate with vendors when appropriate
• Populate databases during initial system build
• Collect information on system enhancements and functionality needs
• Analyze data conversion needs and validate interface data
• Develop and document project team procedures and establish change-control processes
• Participate in training development and delivery
• Troubleshoot problems and investigate end-user questions
• Work with report writers to ensure required reports are available
• Prioritize and implement system changes and evaluate new release functionality
• Communicate with Epic representatives and the end-user community
• Provide end-user support during implementation and assist with application roll-outs
• Identify, communicate, and resolve system issues
• Perform other duties as assigned

Epic Analyst

Communications

• Troubleshoot basic incident and problem tickets involving hardware or software issues within established service-level agreements
• Escalate unresolved issues appropriately
• Perform moves, adds, changes, project support, and status updates for Unified Communications and Contact Center systems across Prisma Health facilities
• Interact with Network Engineers and Senior Network Engineers on complex network and unified communications projects
• Provide documentation support for Unified Communications, Contact Center, and Legacy Voice systems
• Monitor Unified Communications infrastructure and maintain UC monitoring tools
• Provide technical investigation to isolate issues and develop strategies to restore or activate services
• Support Network Engineers and Senior Network Engineers with projects, upgrades, and network and telephony troubleshooting
• Participate in on-call rotation and after-hours cutover support
• Handle incidents, problems, and requests within defined IT service-level agreements
• Perform other duties as assigned

Unified Communications Administrator

Financial Planning and Analysis

• Resolve patient accounts through timely and appropriate financial counseling and collections
• Collect deductibles, co-pays, co-insurance, self-pay amounts, and other payments
• Perform in-depth demographic and financial assessments, generally at the bedside, to determine appropriate payor sources
• Assist patients with financial assistance, outside agency referrals, Social Security Administration appointments, and disability determination processes
• Interview patients or representatives to obtain accurate demographic and financial information in accordance with HIPAA guidelines
• Explain insurance terms and estimated financial responsibility; request and receive payments and issue receipts
• Monitor high-dollar accounts and ensure accurate information for timely submission and reimbursement
• Initiate authorization and insurance verification processes and communicate changes to relevant departments
• Coordinate and monitor Department of Health and Human Services applications
• Collaborate with Social Work and Outcomes Management to support appropriate patient care continuums
• Maintain revenue cycle knowledge through review of payor regulations and guidelines
• Complete special revenue-cycle projects, including complex patient reviews and financial counseling support at other facilities
• Escalate issues to appropriate management

Patient Financial Specialist

• Interview patients or other sources to collect financial, demographic, employment, and insurance information
• Enter accurate information into computer databases, access Sovera, and scan documents
• Follow up on incomplete or missing information
• Verify insurance coverage and benefits and document verification in the system
• Assign appropriate insurance plans and ensure insurance priorities are correct
• Initiate pre-certification processes and obtain signed waivers when required
• Obtain required signatures and information on forms and documents
• Receive payments, issue receipts, maintain cash funds and verification logs, and make daily deposits
• Prepare and distribute reports, documents, schedules, productivity logs, collection reports, and patient identification items
• Communicate estimated financial responsibility and request payment before or at service
• Refer patients to payment or financial assistance programs when appropriate
• Perform other duties as assigned

Pharmacist

• Lead, oversee, and ensure successful delivery and management of projects and systems within scope, quality, schedule, and cost constraints
• Serve as a clinical subject matter expert and end user in selecting, planning, and executing products, services, or outcomes
• Initiate projects under pharmacy administration direction to enhance existing operations
• Collaborate with pharmacy executives, directors, functional managers, clinical pharmacists, and non-pharmacy teams
• Coordinate allocated project team members and evaluate productivity, communication, and teamwork
• Oversee deliverables for multiple special projects and systems simultaneously
• Identify project/system strengths, weaknesses, opportunities, and risks
• Assess feasibility through research and stakeholder engagement
• Collect requirements, objectives, and acceptance criteria from sponsors and stakeholders
• Identify, prioritize, and schedule deliverables, milestones, and activities
• Estimate resource requirements, activity durations, and costs
• Prepare and update project documentation, including charters, work breakdown structures, project sign-offs, and lessons learned
• Monitor project/system activities and ensure information accuracy, quality, and integrity
• Perform risk assessments and implement mitigation plans
• Ensure results meet agreed-upon business objectives
• Facilitate project closure and transition deliverables to functional teams
• Evaluate workflows and develop process improvement initiatives
• Solve workflow problems and incorporate stakeholder feedback
• Standardize and customize workflow initiatives for individual clinical sites
• Facilitate collaboration and communication among operational, clinical, and ancillary staff
• Guide and educate project/system and operational stakeholders
• Resolve and prevent conflicts
• Perform other duties as assigned

Pharmacist – System Specialist

Therapist

• Plans and implements individualized physical therapy treatment programs
• Performs initial evaluations, re-evaluations, standardized evaluations, and physical therapy examinations
• Establishes treatment goals and designs, revises, and manages plans of care
• Provides physical therapy treatment and participates in patient discharge planning
• Collaborates with interdisciplinary treatment teams and coordinates care with other services
• Reassesses patient status and modifies goals and treatments as indicated
• Educates and trains patients, families, and caregivers regarding diagnoses, progress, and long-term functional outcomes
• Completes plan-of-care, patient/family education, treatment, discharge, and medical-record documentation
• Attends staff meetings, team meetings, and mandatory in-services
• Assists with departmental equipment and supplies
• Provides supervision, mentorship, feedback, and delegation to Physical Therapists, Physical Therapy Assistants, Rehab Techs, and students
• Establishes annual goals and supports corporate leadership initiatives
• Performs other duties as assigned

Physical Therapist, PRN

• Provide direct and indirect nursing care to employees of client companies
• Triage injured or exposed employees and administer basic first aid
• Prepare employees for MD/NP evaluation and provide case management
• Perform health assessments, document findings, evaluate screening results, make referrals, and conduct follow-up
• Collect and process substance abuse testing specimens and report results
• Draw labs and perform occupational health testing, including audiograms, vision screening, and pulmonary function testing
• Respond to client company representatives regarding employee health matters
• Maintain onsite clinic supplies and educational materials
• Maintain state and federal mandated records, including DHEC, OSHA, TJC, and NRC records
• Support client safety, employee health, wellness, policy development, and operational improvement programs
• Provide clinical duties and backup nursing support at various Employer Health Services locations
• Perform other duties as assigned

Registered Nurse, Employer Health Services

Physician Assistant

• Perform patient care and related administrative duties under the direct supervision of a licensed physician, APRN, or PA
• Perform clinical, technical, administrative, and clerical duties within the scope of training and certification, including point-of-care testing
• Receive critical lab values, report them to the physician, and document notification in the medical record
• Prepare patients for examinations and treatments; record complaints, medications, vital signs, pain screening, and allergies; pend physician orders
• Prepare examination and treatment rooms and maintain supplies and equipment, including cleaning and sterilizing instruments
• Assist physicians with examinations, tests, procedures, and office-based surgery; apply splints, casts, and dressings and remove sutures when competent
• Report and assist during emergencies
• Prepare and administer ordered medications and immunizations after demonstrating competency and passing the medication administration test
• Receive and return clinically related telephone calls after consulting with a physician or registered nurse
• Educate patients and provide printed information about diagnosis, self-care, health promotion, disease prevention, and community healthcare resources; document education in the medical record
• Document patient data and care in medical records
• Complete medical insurance and related forms; communicate with patients, referral sources, and payors
• Complete registration, scheduling, billing, pre-authorization, and other office/clerical duties
• Schedule physician-ordered tests and treatments
• Perform other duties as assigned
• Report to a supervisor, manager, director, or executive in a non-management role

Registered Nurse, Program Coordinator, Pharmacy Nurse Controlled Substance Diversion Investigator

Patient Access Specialist

Senior Health Information Management Inpatient Coding Auditor

Ambulatory Coder III

Senior Charge Capture Analyst

Ambulatory Coder II – Professional Billing

Ambulatory Coder III, Orthopedics

Epic Analyst

Unified Communications Administrator

Patient Financial Specialist

Patient Access Specialist

Pharmacist – System Specialist

Physical Therapist, PRN

Registered Nurse, Employer Health Services

Certified Medical Assistant