Coder - Clinic

Avera Health; Sioux Falls (SD); On-site; USD 30,000 - 43,000; Full time

Benefits offered by this job

PTO from day 1

Retirement benefit matching

Career development

Job summary

Avera Health is seeking a skilled medical coder responsible for daily coding and billing operations in its Sioux Falls clinics. You will assign CPT, ICD-10, and HCPCS codes for charges while adhering to payor guidelines and physician direction.

Responsibilities include resolving coding issues, communicating updates, coordinating insurance appeals, and supporting clinics during busy periods to maximize third-party reimbursement. Strong attention to detail and teamwork are essential.

Qualifications

• Associate's in Coding or Health Information Management and/or 1-2 years relevant experience and/or current certification as a coding specialist.

Responsibilities

• Assign appropriate codes using CPT, ICD-10 and HCPCS for all charges according to guidelines.
• Collaborate with physicians and clinic staff to resolve coding and reimbursement issues and patient concerns.
• Coordinate and/or complete insurance appeals on denied claims due to coding issues.
• Maintain up-to-date coding information in charge documents and reference materials.
• Support clinics during peak periods or transitions and ensure maximum third-party reimbursement.

Skills

Attention to detail

Communication skills

Education

Associate's in Coding or HIM

1-2 years coding experience

Tools

CPT coding

ICD-10 coding

HCPCS coding

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 [e-mail]. At Avera, the way you are treated as an employee translates into the compassionate care you deliver to patients and team members. Because we consider health care a ministry, you can live out your faith, uphold the dignity and respect of all persons while not compromising high-quality services. Join us in making a positive impact on moving health forward.