Over the years, Ophthalmology LTD’s name provides the highest quality of comprehensive medical and surgical eye care. Highly trained ophthalmologists, as well as experienced optometrists, combine their considerable expertise to give each and every patient the best possible care. Ophthalmology LTD delivers treatment for cataracts, glaucoma, and diabetic eye disease, as well as cornea transplants, oculoplastic surgery, retina surgery, vitreoretinal surgery, and pediatric eye care in Sioux Falls.
We are looking for a passionate Medical Coder. This person is responsible for coding clinical and outpatient medical records using the most accurate and appropriate ICD-10-CM and CPT codes in accordance with regulatory coding guidelines and Ophthalmology LTD policy and procedures. If you are passionate about the work you do and the effect your work has on a patient’s experience, this might be a great fit for you! This position is full-time and will work on-site to provide you real-time opportunity to collaborate with the Ophthalmology LTD family.

A summary of the job duties include:

• Demonstrate extensive knowledge of official coding guidelines established by the AMA and CMS with regard to the assignment of ICD-10 and CPT.
• Evaluates medical record documentation to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support outpatient visits.
• Respond to coding questions/issues and reimbursement questions from clinical staff and other departments as necessary.
• Performs scheduled audits of physician coding and documentation to make recommendations for improvements and enhancements.
• Obtains authorizations prior to procedures or surgical services being performed.
• Assist department leadership with research, analysis, and all other special projects.
• Answer phone calls and direct calls to the appropriate areas.
• Financial counseling of patients prior to medical services being performed and work with the Billing/Insurance Manager and/or CEO on exceptions to standard procedures.

Education and Training requirements:

• High School Diploma, or equivalent. Prefer post-secondary education courses in Health Information Management, accounting and/or business. Educational coursework in CPT and ICD coding in medical practice and a thorough understanding of medical terminology and anatomy.
• Minimum of 2 years of medical coding experience in a physician office setting or equivalent with knowledge of various medical payer practices and insurance laws/guidelines (Medicare, Medicaid, Work Comp, VA, and other third-party payers). Ophthalmology coding and billing experience preferred.
• Certification is encouraged (CPC-Certified Professional Coder, OCS-Ophthalmic Coding Specialist)

Please note this job description is not a complete listing of activities, duties, or responsibilities that are required for this job. Duties, responsibilities, and activities may change at any time.
Ophthalmology LTD office hours are Monday – Friday, 8 am – 5 pm. We offer competitive compensation and a comprehensive benefits package including health, dental, 401K, life insurance, AD&D, short and long-term disability, PTO, sick leave, paid holidays, and eye care benefits.

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• Demonstrate extensive knowledge of official coding guidelines established by the AMA and CMS with regard to the assignment of ICD-10 and CPT.
• Evaluates medical record documentation to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support outpatient visits.
• Respond to coding questions/issues and reimbursement questions from clinical staff and other departments as necessary.
• Performs scheduled audits of physician coding and documentation to make recommendations for improvements and enhancements.
• Obtains authorizations prior to procedures or surgical services being performed.
• Assist department leadership with research, analysis, and all other special projects.
• Answer phone calls and direct calls to the appropriate areas.
• Financial counseling of patients prior to medical services being performed and work with the Billing/Insurance Manager and/or CEO on exceptions to standard procedures