Coder III - Outpatient

Avera Health; Sioux Falls (SD); On-site; USD 36,000 - 52,000; Full time

Benefits offered by this job

PTO day 1 for eligible hires

Retirement plan with employer matching

Career development and mentorship

Equal Opportunity Employer

Job summary

Avera Health is seeking a Coder III to accurately assign ICD-10-CM, CPT, and HCPCS codes across outpatient charts for multiple facilities. You will work independently toward quality and production goals and educate other coders as needed.

Responsibilities include denials management support, physician queries, and collaboration with HIM, billing, and providers. This role requires solid knowledge of outpatient coding and adherence to coding guidelines.

Qualifications

• CCS, RHIA, RHIT, and CCS-P certifications within 180 days.
• 4-6 years of coding experience.
• Associate's Health Information Administration or Health Information Technology preferred.
• Experience with outpatient coding and denials management is a plus.

Responsibilities

• Review outpatient charts to assign ICD-10-CM, CPT, and HCPCS codes for multiple facilities.
• Maintain mastery of outpatient coding for surgeries, observations, injections/infusions, and oncology.
• Query physicians to ensure full capture of clinical documentation.
• Assist with denials management and contribute to medical necessity appeals.
• Lead communication between HIM, billing, and providers as needed.

Education

Certified Coding Specialist (CCS) - AHIMA

Registered Health Information Administrator (RHIA) - AHIMA

Registered Health Information Technician (RHIT) - AHIMA

Certified Coding Specialist - Physician-based (CCS-P) - AHIMA

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. $25.50 - $38.00

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 timely and accurate assignment of diagnostic and procedural codes for most types of outpatient charts for multiple facilities within Avera Health, with a focus on the more complex and high-dollar cases. Accurate abstracting along with other reporting and editing function is also a major responsibility. The Coder III works independently to meet quality and production goals for the position. Varied amounts of time will be spent educating Coder I, III and III coders along with helping others with denials management.

What you will do

Review all aspects of a patient's clinical documentation in order to identify the appropriate sequence of ICD-10-CM, CPT, and HCPCS diagnosis and procedure codes for assigned patient charts across Avera's facilities. Understand ICD-10-CM, CPT and HCPC codes in depth, and be willing to update that knowledge through research or other educational opportunities. Focus on determining the appropriate APC/EAPC and/or appropriate medical coding for a variety of outpatient patient types including, but not limited to, surgeries, observation, injections/infusions, and/or oncology. Expected to have a mastery of the majority of all outpatient types in the outpatient service line and code those as needed. Serve as a subject matter expert for other health professionals within Avera on coding related topics. Queries physicians and clinical documentation staff to ensure a full capture of the clinical record. Assist staff with denials management, including the processing of edits, serving as a subject matter expert, or helping to provide input for medical necessity and other related appeals using appropriate coding guideline references. Lead communication between health information management, billing, and providers as needed. Maintains personal quality and production statistics in accordance to service line standards for a Coder I. Adheres to ethical standards regarding coding as set by Avera Health.

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

• Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) within 180 Days or
• Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA) within 180 Days or
• Registered Health Information Tech (RHIT) - American Health Information Management Association (AHIMA) within 180 Days or
• Certified Coding Specialist - Physician-based (CCS-P) - American Health Information Management Association (AHIMA) within 180 Days

Preferred Education, License/Certification, or Work Experience

• Associate's Health Information Administration or Health Information Technology
• 4-6 years of coding experience

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].

Additional Information

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.