Sorry, this job is no longer accepting applications. See below for more jobs that match what you’re looking for!

Senior Coding Denials Analyst Provider Practice - Health Information

Expired Job

Sanford Health Sioux Falls , SD 57101

Posted 2 months ago

Job Title: Senior Coding Denials Analyst Provider Practice | Health Information | Multi-City

City: Fargo

State: Multi-State

Department : CLIN CODING DENIALS

Job Schedule: Full Time

Shift: Days

Hours Per Shift: 8 hr

JOB SUMMARY

Research and analyze coding related claim edits, denials, internal edits, Patient Financial Services (PFS) questions and concerns, as well as coding compliance software audit messages to optimize reimbursement for Sanford. Ability to call Payers to help identify the issue on a particular denial, being able to articulate well for final resolution.

Identify edit and error related trends as well as coding denial trends. Responsible to accurately abstract diagnoses and treatments from documentation to support appropriate ICD-10 and CPT/HCPCS coding. Provides information on findings and trends to enterprise coding denial leadership as requested for use in coder education and other communications.

Requests the development of coding 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 Coding Denial Leadership. Working knowledge of anatomy, physiology, and pathophysiology to understand disease processes, treatment or management of medical or surgical conditions required.

Must have current knowledge in coding schemes and prospective payment systems and clinical practices and technology. Must have knowledge with Remark and Reason codes sent from payers as well as reading a remittance advice. Demonstrates computer skills and knowledge of information systems.

POSITION RESPONSIBILITIES

Analyzes the newest medical coding industry standards and assesses possible impacts on the organization. Uses a variety of computer hardware, operating systems, utilities and applications.

Processes large quantities of detailed information with high levels of accuracy. Communicates effectively with diverse audiences, using appropriate media and language. Follows organization's coding procedures and standards to conduct medical coding practices. Establishes and maintains effective working relationship with each team member.

DEPARTMENT DETAILS

This full time position will work daytime hours that are somewhat flexible after training (6-9mo) 5:00am-11:00pm option, with core 4 hours during 8:00am-5:00pm.

QUALIFICATIONS

Must maintain certification in RHIA, RHIT, CCS, CCS-P, CPC or CPC-H by fulfilling continuing education requirements. Must have extensive knowledge of diagnostic and procedural terminology, ICD-10, CPT-4 and HCPC coding schemes usually acquired through the following programs or certification:

Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Licensed Practical Nurse (LPN), Certified Professional Coder (CPC), Certified Professional Coder - Hospital (CPC-H), Certified Coding Specialist (CCS), or Certified Coding Specialist Professional (CCS-P). Prefer to have at least two years of experience in coding for professional charges, as well as at least two years experience with Medicare and other third party reimbursement. Working knowledge of anatomy, physiology, and pathophysiology to understand disease processes, treatment or management of medical or surgical conditions required.

Must have current knowledge in coding schemes and prospective payment systems and clinical practices and technology.

Demonstrates computer skills and knowledge of information systems. Must be able to effectively train others to achieve maximum accuracy. Must have knowledge of state and federal laws, rules and regulations.

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 .

In compliance with federal law requiring employers to verify new employees' U.S.

employment eligibility, Sanford participates in E-Verify. To learn more click here for English Version at https://e-verify.uscis.gov/emp/media/resourcesContents/EverifyPosterEnglish.pdf or here for Spanish Version at https://e-verify.uscis.gov/emp/media/resourcesContents/EverifyPosterSpanish.pdf .

City: Multi-City

State: Multi-State

Job Function: Revenue Cycle

Job Schedule: Full Time

Shift: Days

Req Number: req24514



See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Download the
LiveCareer app and find
your dream job anywhere
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Coder Hospital Inpatient Health Information Coding

Sanford Health

Posted 2 weeks ago

VIEW JOBS 10/27/2018 12:00:00 AM 2019-01-25T00:00 Job Title: Coder Hospital Inpatient | Health Information Coding | Multi-City City: Bismarck State: Multi-State Department : HIM CODING - IP Job Schedule: Full Time Shift: Days Hours Per Shift: 8 hr JOB SUMMARY Assigns codes to diagnoses and procedures for medical records using current coding classification system and CPT 4 (Current Procedural Terminology, 4th Edition) coding and classification systems. Coding assignments are made for the purposes of reimbursement, research, compliance with federal and state regulations/guidelines and for severity of illness. Must meet productivity and quality standards. Requires ongoing review and adherence to a multitude of regulatory requirements that are constantly changing. Applies professional knowledge and uses critical thinking skills to assign codes to meet various payment groupings and medical necessity. Assigns Diagnosis-Related Group (DRGs) as well as codes for case mix groups (CMGs) for records. Works extensively with electronic medical record and with some paper based medical records. POSITION RESPONSIBILITIES Assigns codes for diagnoses and procedures in the medical record using utilizing ICD-10-CM & PCS coding classification DEPARTMENT DETAILS Working from home is an option after one year and if quality and productivity requirements are met.. This full time position will work 8:00am - 5:00pm on site during training. Once official training is completed with the training team, they are eligible to choose a set schedule between 5:00am - 11:00pm with 4 hours required to be worked during the 8:00am-5:00pm timeframe. QUALIFICATIONS RHIA, RHIT, or CCS required. Incumbents will be highly encouraged to pursue CCS and other coding credentials. New graduates eligible for certification must complete the certification examination at the earliest testing dates following employment, and all subsequent dates thereafter until the exam is satisfactorily completed. If the individual fails the exam two consecutive times, there will be an evaluation by the Department Director who will determine one of the following: (A) Continue employment if overall job performance is satisfactory. If the employee is allowed to continue employment, failure to pass the exam on the third opportunity will result in immediate termination. (B) If performance is not satisfactory, the employee may be terminated. Associate degree in Health Information Technology (or eligible) or Bachelors degree in Health Information Management and/or Certified Coding Specialist (CCS) required. Prior coding classification education required. Previous hospital coding experience highly desirable. Knowledge of DRG and other payment methodologies essential. Prior computer and/or encoder software experience desirable. Work requires extreme attention to detail and work which meets high ethical standards, logical thinking and the ability to acquire an intricate knowledge of system software and hardware. Knowledge of components of the medical record. Extensive knowledge of anatomy, physiology, disease processes and medical terminology. Must be familiar with operative terms and pharmacology. Flexibility and an ability to work in a team environment. Must be able to interpret and decipher physician and other care giver handwriting and documentation. Computer proficiency for use in daily work processes. Work is extremely detailed and requires high accuracy rate to meet regulatory requirements. 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 . In compliance with federal law requiring employers to verify new employees' U.S. employment eligibility, Sanford participates in E-Verify. To learn more click here for English Version at https://e-verify.uscis.gov/emp/media/resourcesContents/EverifyPosterEnglish.pdf or here for Spanish Version at https://e-verify.uscis.gov/emp/media/resourcesContents/EverifyPosterSpanish.pdf . City: Multi-City State: Multi-State Job Function: Revenue Cycle Job Schedule: Full Time Shift: Days Req Number: req25705 Sanford Health Sioux Falls SD

Senior Coding Denials Analyst Provider Practice - Health Information

Expired Job

Sanford Health