Employment Type: Full timeShift: Day Shift Description: Reviews all assigned charge review errors and claim edits for hospital-based services, including surgical procedures. Ensures correct charge capture and coding with proper CPT, HCPCS, and ICD-10 codes, as well as proper modifiers, adhering to local ministry and Trinity practices and policies. May require analyzing medical documentation to verify principle and secondary diagnoses and procedures; assigning diagnostic codes, selecting the surgical/procedural codes and modifiers using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS); performing charge entry; and performing discrepancy resolution. Serves as a liaison between Centralized Coding/Revenue Site Operations and physicians/ clinical sites/departments. Assists in orienting and training new employees in the coding and charge capture area as well as cross-training established coders in new specialties. RemoteHours | Schedule: - Remote position - Day shift hours Highlights and Benefits: - Competitive compensation, DAILYPAY - Benefits effective Day One! No waiting periods. - Full benefits package including Medical, Dental, Vision, PTO, Life Insurance, Short and Long-term Disability - Retirement savings plan with employer match and contributions - Colleague Referral Program to earn cash and prizes - Unlimited career growth opportunities with one of the largest Catholic healthcare organizations in the country - Tuition Reimbursement Position Summary: Responsible for charge capture process for professional charges within the SMHC system, including but not limited to: verifying and/or analyzing medical record documentation to determine the principle and all secondary diagnoses and procedures; and assigning diagnostic and procedural codes using coding guidelines established by the Center for Medicare and Medicaid Services (CMS) and SMHC. Assists in the orientation and training of new employees within the coding and charge capture area. Minimum qualifications: - Minimum - Associates Degree in allied health related field, including classes in medical terminology, anatomy and physiology; or two years of increasingly responsible medical records experience with exposure to medical terminology, anatomy, physiology, and coding; or an equivalent combination of education and experience. - Minimum – Certified Coding Specialist or Certified Professional Coder credential. - One – three (1-3) years of professional coding experience, with multiple surgical specialties preferred - Preferred - prior experience in coding for neurosurgery, thoracic surgery, and / or gynecologic oncology procedures - Effective verbal, written, and interpersonal communication skills with the ability to comfortably interact with diverse populations. - Solid understanding of ICD-9 and CPT coding and medical terminology, with knowledge of Medicare, Medicaid, Health Maintenance Organization and commercial insurance plans. - Ability to maintain accurate records and to prioritize and organize work effectively. - Ability to exercise independent judgment as appropriate within standard practices and procedures. What the Professional Surgical Coder will do: - Performs coding and charge entry of surgical services dropped in Epic with a generic placeholder or PBSUR. - Detailed in code selections. Maintains accuracy of 95% or greater. - Performs accurate resolve of assigned hospital-based and surgical charge review errors and claim edits in Epic, keeping WQ aging < 2 days. - Reviews documentation in Epic or other sources to appropriately determine ICD-10, CPT, HCPCS, and modifier assignment. - Researches all information needed to complete coding process. - Follows daily, weekly & monthly productivity requirements. - Resolves coding discrepancies related to coding and revenue capture. - Participates in the liaison process between the Centralized Coding, Providers, Managers, and Leadership. - Maintains coding credentials (CPC , CCS) current at all times. - Serves as a resource for providers, managers, peers. - Performs other related duties as assigned. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Employment Type: Full timeShift: Day Shift Description: Reviews all assigned charge review errors and claim edits for hospital-based services, including surgical procedures. Ensures correct charge capture and coding with proper CPT, HCPCS, and ICD-10 codes, as well as proper modifiers, adhering to local ministry and Trinity practices and policies. May require analyzing medical documentation to verify principle and secondary diagnoses and procedures; assigning diagnostic codes, selecting the surgical/procedural codes and modifiers using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS); performing charge entry; and performing discrepancy resolution. Serves as a liaison between Centralized Coding/Revenue Site Operations and physicians/ clinical sites/departments. Assists in orienting and training new employees in the coding and charge capture area as well as cross-training established coders in new specialties.Hours | Schedule: - Remote position - Day shift hours Highlights and Benefits: - Competitive compensation, DAILYPAY - Benefits effective Day One! No waiting periods. - Full benefits package including Medical, Dental, Vision, PTO, Life Insurance, Short and Long-term Disability - Retirement savings plan with employer match and contributions - Colleague Referral Program to earn cash and prizes - Unlimited career growth opportunities with one of the largest Catholic healthcare organizations in the country - Tuition Reimbursement Position Summary: Responsible for charge capture process for professional charges within the SMHC system, including but not limited to: verifying and/or analyzing medical record documentation to determine the principle and all secondary diagnoses and procedures; and assigning diagnostic and procedural codes using coding guidelines established by the Center for Medicare and Medicaid Services (CMS) and SMHC. Assists in the orientation and training of new employees within the coding and charge capture area. Minimum qualifications: - Minimum - Associates Degree in allied health related field, including classes in medical terminology, anatomy and physiology; or two years of increasingly responsible medical records experience with exposure to medical terminology, anatomy, physiology, and coding; or an equivalent combination of education and experience. - Minimum – Certified Coding Specialist or Certified Professional Coder credential. - One – three (1-3) years of professional coding experience, with multiple surgical specialties preferred - Preferred - prior experience in coding for neurosurgery, thoracic surgery, and / or gynecologic oncology procedures - Effective verbal, written, and interpersonal communication skills with the ability to comfortably interact with diverse populations. - Solid understanding of ICD-9 and CPT coding and medical terminology, with knowledge of Medicare, Medicaid, Health Maintenance Organization and commercial insurance plans. - Ability to maintain accurate records and to prioritize and organize work effectively. - Ability to exercise independent judgment as appropriate within standard practices and procedures. What the Professional Surgical Coder will do: - Performs coding and charge entry of surgical services dropped in Epic with a generic placeholder or PBSUR. - Detailed in code selections. Maintains accuracy of 95% or greater. - Performs accurate resolve of assigned hospital-based and surgical charge review errors and claim edits in Epic, keeping WQ aging < 2 days. - Reviews documentation in Epic or other sources to appropriately determine ICD-10, CPT, HCPCS, and modifier assignment. - Researches all information needed to complete coding process. - Follows daily, weekly & monthly productivity requirements. - Resolves coding discrepancies related to coding and revenue capture. - Participates in the liaison process between the Centralized Coding, Providers, Managers, and Leadership. - Maintains coding credentials (CPC , CCS) current at all times. - Serves as a resource for providers, managers, peers. - Performs other related duties as assigned. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland. Work Shift: Day (United States of America) Scheduled Weekly Hours: 40 Compensation: Salary Range: $19.00 - $30.50 Union Position: No Department Details Summary 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. Job Description 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. Qualifications 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 Professional Coder-Apprentice (CPC-A), Certified Coding Specialist (CCS), Certified Coding Specialist-Physician based (CCS-P), CCS Healthcare (CCS-H), Certified Outpatient Coder (COC) required. If the associate is not certified at hire, the associate must be so 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 1-877-949-5678 or send an email to talent@sanfordhealth.org.

• Perform complex coding for CPT, HCPCS, and ICD-10 with a focus on high-impact, payer-sensitive services • Lead expansion and validation of new and underutilized codes (e.g., 90785, T1016, G-codes, state-specific Medicaid codes) • Apply and validate advanced modifier usage, including Medicaid and MCO-specific requirements, to ensure accurate reimbursement • Conduct deep-dive research on payer policies, fee schedules, and billing requirements across Medicaid, MCOs, and commercial plans • Establish coding standards and best practices across the organization • Serve as the subject matter expert (SME) for coding logic in automation and AI initiatives • Translate complex coding rules into scalable system logic for upstream claim automation • Perform manual chart reviews using Medical Decision Making (MDM) guidelines • Validate appropriate E/M level selection • Identify opportunities for appropriate upcoding where documentation supports higher acuity • Establish a 'gold standard' baseline for CPT coding accuracy • Lead analysis of coding-related denials and rejections, including diagnosis and modifier-related issues • Identify root causes and drive upstream fixes to prevent recurrence • Provide expert guidance on complex denial scenarios and appeals strategy, particularly for Medicaid and MCO plans • Support review of payment discrepancies (paid vs. expected based on fee schedules) • Provide coding insight into payer behavior and reimbursement variances across Medicaid and MCOs • Work closely with Clinical teams to ensure documentation supports coding accuracy • Partner with RCM leadership on billing strategy and optimization initiatives • Support training and documentation (e.g., SOPs, internal knowledge base content)