Coder III Outpatient

Floyd Valley Healthcare / An Avera Affiliate; Sioux Falls (SD); On-site; USD 35,000 - 52,000; Full time

Benefits offered by this job

PTO available day 1

Employer matching retirement up to 5%

Career development guided by hands-on"

Mentorship and training programs

Job summary

Avera Downtown Building in Sioux Falls seeks a Coder III to assign diagnostic and procedural codes for outpatient charts across multiple facilities. This role focuses on accurate abstracting and meeting quality and production goals while mentoring colleagues and assisting with denials management.

You will review clinical documentation to determine ICD-10-CM, CPT and HCPCS codes, serve as a subject matter expert, and collaborate with HIM, billing, and providers to ensure full, compliant coding.

Qualifications

• AHIMA credentials within 180 days for CCS/RHIA/RHIT/CCS-P.
• Associate's degree in Health Information Administration or IT.
• 4–6 years of outpatient coding experience preferred.

Responsibilities

• Review patient documentation to assign ICD-10-CM, CPT, HCPCS codes for outpatient charts.
• Determine APC/EAPC and medical coding for various outpatient types.
• Serve as subject matter expert on coding topics for health professionals.
• Query physicians to ensure complete capture of records.
• Assist with denials management and related appeals using guidelines.
• Coordinate communication between HIM, billing, and providers.

Skills

CCS

RHIA

RHIT

CCS-P

Education

Associate's Health Information Administration

4-6 years coding experience

Job description

Coder III

Location: Avera Downtown Building-Sioux Falls

Worker Type: Regular

Work Shift: Day Shift (United States of America)

Pay Range: $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

• 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

• 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].