City - Remote SD, SD, United States of America
14 hours ago
Senior Coding Denials Analyst - Outpatient - Full Time

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. 

Work Shift:

8 Hours - Day Shifts (United States of America)

Scheduled Weekly Hours:

40

Salary Range: $24.00 - $38.50

Union Position:

No

Department Details

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.

Job Description

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 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.

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