Coder, Provider Practice - Endocrinology & Diabetes Self-Management

Facility: Remote SD (Central Time) | Location: Remote, SD | Full time, 40 hours per week

About the role

Serve as a resource for providers in understanding covered indications and the supporting documentation. Supports both technical and professional services in provider clinics, Ambulatory Surgery Centers (ASC), and hospital professional services. Maintains a thorough understanding of National Correct Coding Initiative (NCCI) edits and relative value units. Understands and supports Medicare and Commercial Carrier workflows related to daily coding, denial review, and appeals management, including preparation of supporting documents for the appeal process. Monitors and validates physician charge capture.

Self-motivated with the ability to work independently, multi-task, problem solve, and make informed, accurate recommendations to medical professionals. Participates in coding team meetings and serves as a subject matter expert.

Responsibilities

• Review medical documentation from physicians and other healthcare providers; assign modifiers, diagnostic, and procedure codes for symptoms, diseases, injuries, surgeries, and treatments according to official classification systems and standards.
• Use relevant policies, procedures, and individual judgment to determine whether events or processes comply with laws, regulations, or standards.
• Provide accurate and timely ICD-10-CM coding of diagnoses, HCPCS, and CPT coding in accordance with official coding standards, regulatory compliance guidelines, and company procedures.
• Review and audit medical record documentation to reflect healthcare coding and substantiate appropriate service reimbursement.
• Convey coding guidelines to physicians and other healthcare providers to improve the accuracy of medical record documentation.

Requirements

• Associate degree in Health Information Technology or Certification in Coding required.
• 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), or Certified Outpatient Coder (COC) required. If not certified at hire, must obtain certification within one year.
• Specific knowledge of diagnostic and procedural terminology, coursework in ICD, CPT, HCPCS coding schemes, medical terminology, or human anatomy/physiology preferred.
• Computer skills, ability to interpret, analyze, and abstract data/documentation, problem-solving skills, self-motivation, and strong time management and organizational skills.

Benefits

Sanford offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, benefits may include:

• Health insurance
• Dental insurance
• Vision insurance
• Life insurance
• 401(k) retirement plan
• Work/life balance benefits
• Generous time off package to maintain a healthy work-home balance

For more information about Total Rewards, visit sanfordcareers.com/benefits.

Pay

Salary range: $20.50 - $33.00 per hour

Schedule

• Full time, 40 hours per week
• 8-hour day shifts
• Flexible schedule