Senior Coding Denials Analyst, Outpatient

Remote, SD
Commute links off-site

Job Details

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.

Benefits

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 talent@sanfordhealth.org .

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.

Req Number: R-0223815
Job Function: Revenue Cycle
Featured: No

Other Jobs You Might Like

Loading...

Equal Employment Opportunity

Sanford and its affiliate brands have consistently operated under the principle of equal treatment for all persons; all qualified applicants will receive consideration for employment without regard to race, color, creed, religion, national origin, gender, gender identity, age, sexual orientation, genetic information, marital status, disability, military or veteran status, in regard to public assistance or any other basis prohibited by applicable federal, state or local law.

SAFE: Sanford Accountability for Excellence

As caregivers, we commit to the safety of those we serve and each other by creating a psychologically safe environment where everyone is included and safe to learn, contribute and raise concerns without fear of negative consequences. When people come to us, they rely on us to keep them safe from harm, do all we can to heal them, and treat them with empathy and compassion – all while embracing our connection to each other. Safety is part of our culture and defines the care we provide, and how we deliver on our universal commitment to a higher level of service and exceptional care.

If you are an individual with a disability and would like to request an accommodation for help with your online application, please call (877) 673-0854 or send an email to hrhelp@sanfordhealth.org.

In compliance with federal law requiring employers to verify new employees' U.S. employment eligibility, Sanford participates in E-Verify. To learn more about your right to work: English Version or Spanish Version.

Important Notice

There has been a recent increase in recruitment scams. Protect yourself by learning common indications of a fake job scam. Read More.

If you have questions about the legitimacy of an employment offer from Sanford Health, contact hrhelp@sanfordhealth.org.