Key Facts

Remote From:

Full time

English

Hard Skills

ICD Coding (ICD-9/ICD-10) CPT Coding Medical Coding Medical Record Management Procedure Codes Policy Enforcement Relative Value Unit Medical Coding Diagnosis Codes Data Abstraction Clinical Documentation Anatomy Medical Abbreviations Communicating With Patients

Other Skills

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Multitasking
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Time Management
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Organizational Skills
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Computer Literacy
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Self-Motivation
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Problem Solving

Roles & Responsibilities

Associate degree in Health Information Technology or Certification in Coding
Certification such as RHIA, RHIT, CPC, CPC-A, CCS, CCS-P, CCS-H or COC; if not certified at hire, must obtain within one year
Knowledge of ICD-10-CM/PCS, CPT, HCPCS coding; familiarity with medical terminology or anatomy/physiology
Strong computer skills, problem-solving ability, and capability to work independently with effective communication with healthcare providers

Requirements:

Review physician documentation and assign ICD-10-CM/PCS, HCPCS, and CPT codes in accordance with official coding standards and company procedures
Support Medicare and Commercial payer workflows including denial review, appeals management, and preparation of supporting documentation
Monitor physician charge capture, participate in coding team meetings, and communicate coding guidelines to clinicians to improve documentation accuracy
Audit medical records to ensure accurate coding and appropriate reimbursement, maintaining compliance with policies and regulatory guidelines, including NCCI edits

Sanford Health

About Sanford Health

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland. Headquartered in Sioux Falls, South Dakota, the organization serves more than one million patients and 220,000 health plan members across 250,000 square miles. The integrated health system has 47 medical centers, 2,800 Sanford physicians and advanced practice providers, 170 clinical investigators and research scientists, more than 200 Good Samaritan Society senior care locations and world clinics in 8 countries around the globe. Learn more about Sanford Health's commitment to shaping the future of rural health care across the lifespan at sanfordhealth.org or Sanford Health News.

Company type: Large

Founded: 2018

Company size: 10001

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Job description

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

Work Shift:

8 Hours - Day Shifts (United States of America)

Scheduled Weekly Hours:

Salary Range: $19.00 - $30.50

Union Position:

Department Details

Our Coders review medical documentation, assign appropriate codes (ICD-10, HCPCS, CPT), and ensure compliance with coding standards, regulations, and company procedures.
The position requires strong problem-solving skills, effective communication with medical professionals to improve documentation accuracy and the ability to work independently,
We offer flexible hours and the ability to work remotely.

Pay starts at $19.00/hr with additional credit given for work experience relative to this role.

Summary

Serve as a resource for providers in understanding covered indications and the supporting documentation. Supports both technical and professional services in provider clinic as well as Ambulatory Surgery Centers (ASC) and in addition hospital professional services. Maintains a thorough understanding of National Correct Coding Initiative (NCCI) edits and relative value units as appropriate for the role.

Job Description

Understands and supports the Medicare and Commercial Carrier workflows related to daily coding and denial review and appeals management, including the preparation of supporting documents and information to support the appeal process. Monitors and validates physician charge capture. Self-motivated with the ability to work independently, multi-task, problem solve and make informed and accurate recommendations to medical professionals based on current information. Participates in coding team meetings and serves as a subject matter expert. Reviews medical documentation from physicians and other healthcare providers; assigns modifiers, diagnostic and procedure codes for symptoms, diseases, injuries, surgeries and treatments according to official classification systems and standards. Uses relevant policies, procedures, and individual judgment to determine whether events or processes comply with laws, regulations, or standards. Provide accurate and timely international classification of disease – tenth edition – clinical modification (ICD-10) - CM coding of diagnoses, Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) coding, and in accordance with official coding standards, regulatory coding compliance guidelines and company procedures. Review and audit medical record documentation accurately to reflect healthcare coding and to substantiate appropriate service reimbursement. Conveying coding guidelines to physicians and other healthcare providers to improve the accuracy of medical record documentation. Computer skills, the ability to interpret, analyze and abstract data/documentation, have good problem-solving skills, be self-motivated and have good time management and organizational skills.

Qualifications

Associate degree in Health Information Technology or Certification in Coding required.

Specific knowledge of diagnostic and procedural terminology, successful coursework from an accredited institution in International Statistical Classification of Diseases (ICD) diagnosis, Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) coding schemes, medical terminology or human anatomy/physiology is preferred.

Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), Certified Professional Coder-Apprentice (CPC-A), Certified Coding Specialist (CCS), Certified Coding Specialist-Physician based (CCS-P), CCS Healthcare (CCS-H), Certified Outpatient Coder (COC) required. If the associate is not certified at hire, the associate must be so within one year of the date of hire.

Sanford is an EEO/AA Employer M/F/Disability/Vet.

If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org.