Job Summary
Provide leadership to coding staff in assigning accurate and timely codes to medical records for optimal reimbursement, data collection, and statistical reporting.
Provide accurate information, education and reviews regarding coding to assure the most effective reimbursement methods are identified and utilized and to assure compliance.
Responsible for meetings with physicians to provide feedback, educate, and train on appropriate documentation. Report findings of analyzed coding data to upper management and executives on any discrepancies or variances amongst the industry data compared to departmental data.
Validate any potentially missed professional revenue, running reports to find missed charges, validate charges as shown on billing, assist with template development, research new coding guidelines, information sharing new coding guidelines with others, have an understanding of service and revenue routing, review payer audits.
Provide responses to any reviewed patient related concerns to charges associated with service received. Provide input as needed into pricing of services, monitor, and analyze reimbursement-related issues.
Knowledge and understanding of ancillary coding services. Review updated payer bulletins. Inform clinics / providers of any updates and / or changes, related with charges and codes.
Perform other duties as assigned by the manager and / or director. Have a working knowledge of anatomy, physiology and pathophysiology to understand disease processes, treatment or management of conditions either medically or surgically.
Computer skills, the ability to interpret, analyze and abstract data / documentation, and have good problem-solving skills.
Current in coding schemes and have knowledge of prospective payment systems, insurance policies, drug / pharmacy related coding rules and documentation process, and clinical practices and technology.
Specific knowledge of diagnostic and procedural terminology, international classification of disease, tenth edition (ICD-10), current procedural terminology (CPT) and healthcare common procedure coding system (HCPCS) coding schemes.
Demonstrate leadership skills, excellent communication, and proven ability to effectively train others and motivate people in realizing and attaining their goals.
Assist with training of personnel, dealing with employee issues / behaviors, assisting with hiring / termination.
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.
Prefer to have at least three years of experience in coding for professional charges, as well as experience with Medicare and other third party payors.
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist-Physician based (CCS-P), CCS Healthcare (CCS-H), Certified Outpatient Coder (COC) required.
Benefits
Sanford Health offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a (k) retirement plan, work / life balance benefits, and a generous time off package to maintain a healthy home-work balance.
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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 or send an email to .
Sanford Health has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.
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