Coder, Provider Practice - Clinic Coding

Job description          

**Job Title: ** Coder, Provider Practice | Clinic Coding | Multi-City

**City: ** Multi-City

**State: ** Multi-State

**Department** **: ** Coder Provider Practice - Sioux Falls

**Job Schedule: ** Full Time

**Shift: ** Days

**Hours Per Shift: ** Other


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.

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.


Demonstrates experience in participating in productive collaborative processes. Establishes and maintains productive working relationships within and outside of own area. Demonstrates an ability to meet own responsibilities. Assures accuracy using basic validation and cross-checking techniques. Identifies issues and communicates with others when a decision needs to be made. Delivers written and oral communication, responds to questions and concerns, and produce specific outcomes and impact. Follows organization's coding procedures and standards to conduct medical coding practices. Discusses major health information coding guidelines and specifications (e.g. ICD, 10th Edition). Identifies key medical information coding concepts and features such as Current Procedural Terminology (CPT) and International Classification of Diseases (ICD). Conveys medical record documentation requirements to physicians to ensure that coding guidelines are applied for appropriate information recording.


Coding specialty will be Gastroenterology. Hours for this full time position are somewhat flexible, Monday-Friday, can choose a set schedule between 5:00am - 11:00pm with 4 hours required to be worked during the 8:00am-5:00pm timeframe.


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 Coding Specialist (CCS), Certified Coding Specialist-Physician based (CCS-P), CCS Healthcare (CCS-H), Certified Outpatient Coder (COC)Â required. If the associate is not certified at hire, the associate must be become so within one year of the date of hire.

**About Sanford Health: **

At Sanford Health, we are dedicated to the work of health and healing.

Every day, we show that commitment by delivering the highest quality of care to the communities we serve.

We are leaders in health care and strive to provide patients across the region with convenient access to expert medical care, leading-edge technologies and world-class facilities.

In addition to strong clinical care, we are also committed to research, education and community growth.

We engage in medical research to not only discover innovative ways to provide care, but also cures for common diseases.

We continuously seek new ways to achieve our vision of improving the human condition here in your community, across the region and around the world.

The entire team at Sanford Health recognizes the value of healthy families and communities.

We continue to gain momentum and expand our reach. Together, we can make a positive difference now, and in the future.

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 .

**City: ** Multi-City

**State: ** Multi-State

**Job Function: ** Revenue Cycle

**Job Schedule: ** Full Time

**Shift: ** Days

**Req Number: ** WD12262
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