Coder, Provider Practice

Sanford; United States; On-site; USD 28,000 - 45,000; Full time

Job summary

Sanford Health is seeking a Certified Coding professional to support daily coding tasks across clinic and ASC settings. You will review medical records, assign ICD-10-CM/PCS, CPT and HCPCS codes, and prepare documentation for denials and appeals. The role requires independent work, accuracy, and knowledge of NCCI edits.

The position emphasizes compliance, timely coding, and collaboration with physicians and clinical staff to ensure proper reimbursement.

Qualifications

• Associate degree or higher in health information technology or coding required.
• Professional coding credentials preferred or required within one year of hire.
• Knowledge of ICD-10-CM/PCS, CPT, HCPCS coding and related regulatory guidelines.

Responsibilities

• Understand and support Medicare and commercial coding workflows and denial review.
• Prepare supporting documents for appeals and ensure accurate charge capture.
• Review medical documentation to assign appropriate modifiers, codes and diagnoses.
• Educate providers on coding guidelines to improve documentation accuracy.
• Audit records for compliance with coding standards and company procedures.

Education

Associate degree in Health Information Technology

Certification in Coding

Job description

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland.

Work Shift:

8 Hours - Day Shifts (United States of America)

Scheduled Weekly Hours:

40

Compensation:

Salary Range: $20.50 - $33.00

Union Position:

No

Department Details

Flexible Scheduling - 8 hours days

Summary

Serve as a resource for providers in understanding covered indications and the supporting documentation. Supports both technical and professional services in provider clinic as well as Ambulatory Surgery Centers (ASC) and in addition hospital professional services. Maintains a thorough understanding of National Correct Coding Initiative (NCCI) edits and relative value units as appropriate for the role.

Job Description

Understands and supports the Medicare and Commercial Carrier workflows related to daily coding and denial review and appeals management, including the preparation of supporting documents and information to support the appeal process.

Monitors and validates physician charge capture.

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

Reviews medical documentation from physicians and other healthcare providers; assigns modifiers, diagnostic and procedure codes for symptoms, diseases, injuries, surgeries and treatments according to official classification systems and standards. Uses relevant policies, procedures, and individual judgment to determine whether events or processes comply with laws, regulations, or standards.

Provide accurate and timely international classification of disease - tenth edition - clinical modification (ICD-10) - CM coding of diagnoses, Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) coding, and in accordance with official coding standards, regulatory coding compliance guidelines and company procedures.

Review and audit medical record documentation accurately to reflect healthcare coding and to substantiate appropriate service reimbursement. Conveying coding guidelines to physicians and other healthcare providers to improve the accuracy of medical record documentation.

Computer skills, the ability to interpret, analyze and abstract data/documentation, have good problem-solving skills, be self-motivated and have good time management and organizational skills.

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.

Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), Certified Professional Coder-Apprentice (CPC-A), 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), Certified Outpatient Coder (COC) required. If the associate is not certified at hire, the associate must be so within one year of the date of hire.

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 1-877-949-5678 or send an email to [e-mail].