Senior Coding Denials Analyst, Outpatient

Good Samaritan Society; South Dakota; Remote; USD 80,000 - 100,000; Full time

Job summary

A leading healthcare provider is seeking a Senior Coding Denials Analyst to optimize reimbursement and enhance coding practices. This role involves detailed analysis of claim edits and trends, requiring extensive coding knowledge and certifications. The ideal candidate will have a robust background in coding systems and customer service skills, contributing to ongoing improvements in the revenue cycle.

Benefits

Health Insurance

Paid Time Off

401(k) Retirement Savings Plan

Voluntary Benefits

Company Paid Benefits

Qualifications

• Must have two years' experience in hospital outpatient coding.
• Must maintain certification in RHIA, RHIT, CCS, CPC or COC.

Responsibilities

• Research and analyze inpatient related claim edits and denials.
• Provide feedback on coding related software edits and denial issues.
• Participate in development of validation checks for coder education.

Skills

Knowledge of ICD-9

Knowledge of ICD-10

Knowledge of CPT-4

Knowledge of HCPCS

Customer service skills

Education

Registered Health Information Administrator (RHIA)

Registered Health Information Technician (RHIT)

Certified Professional Coder (CPC)

Certified Outpatient Coding (COC)

Certified Coding Specialist (CCS)

Certified Coding Specialist Professional (CCS-P)

Job description

For more information about Total Rewards, visit https://sanfordcareers.com/benefits

Sanford Health

Sanford Health Senior Coding Denials Analyst, Outpatient Remote , South Dakota Apply Now Current Employees Apply Here

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Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

Health Insurance

We offer multiple health plan options allowing you flexibility to choose what fits best for your family.

Paid Time Off

With our paid time off program we encourage you to take time away to re-charge and re-fresh.

Voluntary Benefits

A large assortment of voluntary benefits allow you to customize your benefit package.

Company Paid Benefits

Eligible employees receive base life insurance and disability at no cost to help with financial needs.

401(k) Retirement Savings Plan

We provide a generous employer match contribution while you put away money for your retirement.

Employees get access to a wide selection of discounts/perks both local and nationwide.

Careers With Purpose

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

Facility: Remote SD (Central Time)
Location: Remote, SD
Address:
Shift: 8 Hours - Day Shifts
Job Schedule: Full time
Weekly Hours: 40.00
Salary Range: $24.00 - $38.50

Job Summary

Research and analyze inpatient related claim edits, returns from providers, denials, internal edits, patient complaints, Patient Financial Services questions and concerns as well as coding compliance software audit messages to optimize reimbursement for Sanford. Identify, edit and error related trends. Provides information on findings and trends to enterprise coding leaders as requested for use in coder education and other communications. Participates in the development of validation checks and other edits to provide real-time opportunities for coders to receive front-end alerts

during the coding process, aiding in revenue cycle enhancements. Provides feedback and direction on coding related software edits, denial issues, reimbursement trends and billing/coding errors to providers, coding and reimbursement staff, and organizational departments such as Patient Financial Services, Compliance, and clinical departments.

Qualifications

Must have extensive knowledge of diagnostic and procedural terminology, ICD-9, ICD-10, CPT-4 and HCPCS coding schemes usually acquired through the following programs or certification: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), Certified Outpatient Coding (COC), Certified Coding Specialist (CCS), or Certified Coding Specialist Professional (CCS-P).

Must have two years' experience in hospital outpatient coding. Must have a working knowledge of anatomy, physiology, and

pathophysiology to understand disease processes, treatment or management of medical or surgical conditions. Must have current knowledge in coding schemes and prospective payment systems and clinical practices and technology. Must have computer skills and knowledge of information systems. Must be able to effectively train others to achieve maximum accuracy. Must also possess

knowledge of state and federal laws, rules and regulations. Ability to effectively interact with others and strong customer service related skills.

Must maintain certification in RHIA, RHIT, CCS, CPC or COC by fulfilling continuing education requirements. If the associate is not certified at hire, the associate must be certified within one year of the date of hire.

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 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits .

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 1-877-673-0854 or send an email to [e-mail] .

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.