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.
See yourself at Sanford!
Facility: Sanford Business Center Building
Location: Sioux Falls, SD
Address: 2200 E Benson Rd, Sioux Falls, SD 57104, USA
Job Schedule: Full time
Weekly Hours: 40.00
Responsible for overall design, implementation and optimization of professional coding for Sanford Health. Provides leadership in the areas of clinic and hospital professional coding and hospital and clinic recovery audit contractors (RAC). Provides strategic planning and technical leadership and input on information systems. Directs and provides leadership to professional coding staff. Directs the processes and resolution of clinic and hospital professional coding related denials.
Provides direction and leadership for denial management and RAC activity to include integrity of appeal process and policy. Demonstrates ability to develop, evaluate, monitor, educate, and analyze health system coding processes on a daily basis to increase productivity, ensure compliance is met utilizing all recognized coding guidelines and all payor policies and guidelines and the goals of Sanford Health are met.
Responsible for operational budget and strategic initiatives and formulation of Sanford Health's coding operating model and enhancement of coding related services throughout the system in order to drive and meet the goals of revenue services. Develops reporting tools for Sanford leadership to help in fiscal budget planning and decision making, as well as education to reduce denial/RAC activity for the system.
Collaborates and coordinates with various Sanford Health leaders to ensure coding integrity and accurate data collection is achieved to support a seamless continuum of care, supporting provider compensation models, compliant processes, optimal reimbursement and efficient revenue cycle functions. Strengthens relationships by communicating department activity and outcome with other managers and service areas.
Sets vision and direction for developing and maintaining relationships between the Sanford provider community and coding. Supports Sanford's efforts to influence public policy at the state and federal levels.
Bachelor’s degree in a financial-related field with a strong emphasis in health care finance.
Minimum seven years of directly related work experience and extensive knowledge of basic and underlying Current Procedural Terminology (CPT) coding practices required.
Additionally, possess extensive knowledge of state and federal laws, rules and regulations and must be able to accurately interpret and apply these laws, rules and regulations. Experience in health care finance, rate setting procedures, and intermediary auditing related to Medicare. Experience analyzing and maximizing third party reimbursement, and experience with computerized reporting systems.
Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC) or Certified Coding Specialist (CCS) certification required.
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, sick leave and paid time off. To review your benefit eligibility, visit https://sanfordhealth.jobs/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 firstname.lastname@example.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.
Job Function: Revenue Cycle
Req Number: R-37921