Medical Coder

Job Description

Medical Coder

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.

Position Overview

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.

What You'll Do

Coding & Documentation

• 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.

Compliance & Quality

• 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.

Patient & Financial Support

• 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.

Collaboration & Teamwork

• 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.

Qualifications

Required

• 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.

Preferred

• 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.

What Makes You Successful

• 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

Why Ophthalmology LTD?

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 teamwork, accountability, and continuous improvement while creating an environment where employees can build meaningful and rewarding careers.

We offer:

• Competitive compensation
• Comprehensive health, dental, and vision benefits
• 401(k) retirement plan
• Life insurance, AD&D, and disability coverage
• Paid time off and paid holidays
• Eye care benefits
• Monday through Friday daytime schedule
• Professional and supportive team environment

Our Commitment

We believe exceptional patient care begins with exceptional people. At Ophthalmology LTD, we are committed to fostering a culture built on compassion, integrity, teamwork, and excellence. If you're looking for an opportunity to make an impact while working alongside dedicated healthcare professionals, we'd love to hear from you.

Please note this description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the position. Responsibilities may change as business needs evolve.

We are an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, age, or any other characteristic protected by law.