Medical Coder

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Full Time Clerical SIOUX FALLS, SD, US

2 days ago Requisition

Ophthalmology LTD | Sioux Falls, SD

For more than 50 years, Ophthalmology LTD has been a trusted leader in comprehensive medical and surgical eye care throughout the Sioux Empire and surrounding region. Our highly trained ophthalmologists and experienced optometrists work together to provide exceptional care across a wide range of specialties, including cataract surgery, glaucoma treatment, retina and vitreoretinal care, cornea services, oculoplastic, and pediatric ophthalmology.

We are seeking a detail-oriented Medical Coder to join our team. This position plays a vital role in ensuring accurate coding, regulatory compliance, and appropriate reimbursement for services provided throughout our practice. The ideal candidate values accuracy, enjoys problem-solving, and understands how their work contributes to both the patient experience and the overall success of the organization.

This is a full-time, on-site position located in Sioux Falls, South Dakota. We are not currently offering hybrid or remote work arrangements for this role.

The Medical Coder is responsible for reviewing and coding clinical and outpatient medical records using the most accurate ICD-10-CM and CPT codes in accordance with regulatory coding guidelines and Ophthalmology LTD policies and procedures. This individual collaborates closely with providers, clinical staff, billing personnel, and leadership to support accurate documentation, compliant coding practices, and optimal reimbursement.

• Apply ICD-10-CM and CPT coding guidelines accurately and consistently.
• Review clinical documentation to ensure accurate assignment of diagnosis and procedure codes.
• Evaluate medical records to optimize reimbursement while maintaining coding integrity and compliance.
• Demonstrate thorough knowledge of coding guidelines established by the AMA, CMS, and third-party payers.
• Identify documentation opportunities and work collaboratively with providers and staff to improve coding accuracy.

• Respond to coding and reimbursement questions from physicians, clinical staff, and other departments.
• Perform coding audits and documentation reviews, providing recommendations for improvement.
• Stay current on coding updates, payer requirements, and regulatory changes.
• Assist with compliance initiatives and special projects as assigned.
• Obtain authorizations for procedures and surgical services when required.
• Assist with patient financial counseling prior to services being rendered.
• Collaborate with leadership regarding exceptions to standard financial procedures.
• Support communication between departments to ensure a positive patient experience.
• Answer and direct incoming calls appropriately.
• Assist department leadership with research, reporting, and analysis.
• Promote a positive, professional, and collaborative work environment.
• Contribute to process improvements that support efficiency and exceptional patient care.

• High School Diploma or equivalent.
• Minimum of two years of medical coding experience in a physician office or comparable healthcare setting.
• Working knowledge of ICD-10-CM, CPT, and medical terminology.
• Understanding of payer requirements and insurance guidelines, including Medicare, Medicaid, Workers' Compensation, VA, and commercial insurance plans.
• Strong organizational skills and attention to detail.
• Excellent communication and problem-solving abilities.

• Post-secondary coursework in Health Information Management, business, accounting, or a related field.
• Ophthalmology coding experience.
• Certified Professional Coder (CPC), Ophthalmic Coding Specialist (OCS), or other relevant coding certification.
• Experience working with surgical coding and prior authorizations.

• Exceptional attention to detail
• Strong analytical and critical thinking skills
• Commitment to accuracy and compliance
• Professionalism and integrity
• Ability to prioritize competing responsibilities
• Strong communication and collaboration skills
• Desire to continuously learn and adapt to industry changes

At Ophthalmology LTD, every team member contributes to our mission of helping patients preserve and improve their vision. As a physician-owned practice, we value…