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Coder - Clinic

Role overview

Qualifications

  • Associate's in Coding or Health Information Management
  • 1-2 years relevant experience
  • Current certification as a coding specialist (e.g., CCS, CPC, RHIT)

Responsibilities

  • Assign appropriate codes using CPT, ICD-10 and HCPC’s for charges
  • Work with physicians and clinic management to resolve coding issues
  • Communicate coding updates to appropriate individuals
  • Coordinate insurance appeals on denied claims due to coding issues

Key facts

Hard skills

Other skills

  • Communication
  • Teamwork
  • Problem Solving

About the company

Avera Health logo

Avera Health

Hospitals & Health Care

Avera Health, an integrated health system based in Sioux Falls, SD, is committed to making a positive impact in the health and wellness of persons and communities. Avera provides qualities care in SD, MN, IA, NE and ND through 315 locations in 100 communities and serves 1 million individuals. Our 20,000 employees live out our Christian values of compassion, hospitality and stewardship daily in patient encounters and through our non-clinical support teams. Learn how you can make an impact and move health forward at Avera.org/Careers

Company details

IndustryHospitals & Health Care
Company size5001 - 10000

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Job description

Location:

Avera Downtown Building-Sioux Falls

Worker Type:

Regular

Work Shift:

Day Shift (United States of America)

Pay Range:

The pay range for this position is listed below. Actual pay rate dependent upon experience.

$21.75 - $31.25

Position Highlights


You Belong at Avera

Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.


A Brief Overview

Responsible for the daily coding and billing operations of the clinics as assigned.

What you will do

  • Assign appropriate codes using CPT, ICD-10 and HCPC’s for all charges according to national and payor guidelines and physician direction.
  • Work with physicians and clinic management staff to resolve coding and reimbursement issues and patient concerns.
  • Communicate coding updates and changes to appropriate individuals.
  • Coordinate and/or complete insurance appeals on denied claims due to coding issues.
  • Assist in the design of charge documents for the clinic and maintain documents with the most current coding information.
  • Ensure maximum third party reimbursement through financial planning, familiarity with payor contracts and pursuit of appropriate reimbursement on all claims.
  • Investigate and report on all current reimbursement developments on third party payor functions when unable to resolve them and their remittances.
  • Review all insurance bulletins and refers information to other personnel as appropriate.
  • Provide support to clinics during periods of increased workload, periods of transition, or on an as needed basis.

Essential Qualifications

The individual must be able to work the hours specified. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.

Required Education, License/Certification, or Work Experience:

  • Associate's in Coding or Health Information Management and/or 1-2 years relevant experience and/or current certification as a coding specialist.
  • AHIMA Membership - American Health Information Management Association (AHIMA) within 1 Year or
  • Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) within 1 Year or
  • Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC) within 1 Year or
  • Registered Health Information Tech (RHIT) - American Health Information Management Association (AHIMA) within 1 Year
  • 1-3 years Coding or patient account experience or outlined degree or certification.

Expectations and Standards

  • Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community.
  • Promote Avera’s values of compassion, hospitality, and stewardship.
  • Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
  • Maintain confidentiality.
  • Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
  • Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.

Benefits You Need & Then Some

Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future.

  • PTO available day 1 for eligible hires.

  • Up to 5% employer matching contribution for retirement

  • Career development guided by hands-on training and mentorship

Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org.

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Marcus Rivera

Chief Revenue Officer

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