Organization: Sanford Health
Location: Sioux Falls, SD
Date Job Posted: July 20, 2021
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Provide leadership and direction for functions related to Professional Coding Denials, Professional Coder Training and Auditing. Highly accountable for attainment of organizational goals and sets the organizational direction for professional coding denials and clinic coder training. Accountable for building and maintaining professional coding edits. Responsible for aligning priorities and practices with enterprise-wide revenue cycle goals and initiatives. Embrace the use of the electronic medical record and billing system(s) and other leading technologies to assure efficient and effective process and practices. Maintain expertise and knowledge of EPIC functionality. Working knowledge of professional coding denials and facilities Provider Based Billing (PBB) denials.
Responsible for strategic planning, budget, and implementation of leading edge technology.
Accountable for developing and maintaining applicable coding policies with Sanford internal initiatives as well as regulatory rules. Computer skills and knowledge of information systems. Demonstrated leadership skills and proven ability to effectively train others and motivate people in realizing and attaining their goals. Knowledge of health care finance, and state and federal laws, rules and regulations, and accurately interpret and apply those laws, rules and regulations.
Remain current in coding schemes and knowledge of prospective payment systems and clinical practices and technology. Understanding of intermediary auditing related to Medicare and third party payors. Possess extensive knowledge of coding systems.
Bachelor's Degree in health-related field. In lieu of degree, will accept minimum of six years equivalent and related work experience.
Additionally, have at least seven years of work experience related to coding. Experience in project control, management, budgeting and planning techniques. Minimum of three years experience with Medicare and other third party reimbursement.
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) required.