Job Description

Join our Medical Coding Department to ensure accurate coding of medical bills for injured workers. In this collaborative team environment, critical thinking and teamwork are key. At SFM, we value our motivated employees and offer opportunities for professional growth and work-life balance. Whether you’re an experienced coder or new to the field, your title will reflect your experience.

This role offers a hybrid work model with some office time required.

Hourly Range : $28.14 to $39.40

As a member of the Medical Bill Review team, you will verify the accuracy of medical bill coding to ensure proper reimbursement for services provided to injured workers, in compliance with state workers' compensation guidelines. This role focuses on efficient, high-quality bill reviews and may include investigating billing practices and participating in payment rationale discussions. Maintaining positive relationships with internal and external customers is also key.

Depending on your experience, you may be hired as an Associate Medical Support Representative or Medical Support Representative. SFM offers a flexible hybrid work model with some office time required. Our Corporate Headquarters are located in Minnesota.

Our benefits include:

• Affordable Medical, Dental, Vision Insurance, HSA, FSA
• Flexible hybrid work environment
• Traditional and Roth 401(k) plans with company match
• Company contributions to help pay off student loans
• Monthly home internet allowance
• Free life insurance, STD & LTD
• Opportunities for annual gainshare bonus 
• Pet insurance
• Generous PTO
• 9 paid holidays 
• Paid parental leave
• Annual company-wide volunteer day
• Discounts on gym memberships, fitness apps and weight loss programs
• Adoption financial assistance

What You Will Be Doing:

• Reviews standard medical bills, with minimal direction, in accordance with the appropriate state workers’ compensation guidelines and Company best practices, utilizing the Mitchell System and maintain a level of accuracy in accordance with Company standards and specific custom rules established by SFM.
• Handles and reviews medical bills in a timely fashion and meets production and quality standards per company guidelines and best practices.
• Partners with various vendors and other resources for bill review services as needed.
• Apply’ s learned medical terminology when analyzing medical bills and translates medical coding billing codes per best practices and company protocol and uses the Mitchell system effectively.
• Identifies when overpayments are made and submits refund requests when needed and reports said overpayments to a senior member of the team.
• Processes provider appeals/reconsiderations for standard bill types by resubmitting for payment or sending professional communication regarding needed documentation or workers’ compensation rules.
• Under limited supervision, reviews moderately complex bills in accordance with the appropriate state workers’ compensation guidelines and Company best practices and escalates more complicated matters as needed.
• Reports provider billing practices that are concerning such as potential for overutilization, fraud/abuse or patterns of repeated errors and assists in investigations and obtains guidance before issuing payments seeking guidance as needed.
• Ensures the quality of documentation is appropriate for billed charges.
• Provides high-quality customer support to various business units within the organization, external customers, and business partners.
• Seeks new ways to improve department efficiencies and makes recommendations regarding those improvements, and continues self-development and willingness to learn new skills.
• Participates as an active team member offering new ideas and helps less experienced team members as needed.
• Responds in a timely fashion to customer questions while applying the appropriate workers’ compensation rules and maintains appropriate interactions with persons both within the organization and externally.
• Adheres to standards for Company and best practices and agreements made under the Partnership Agreement with the Strategic Business Units and other teams.

Qualifications We're Looking For:

For the Associate level role ,

• Must have an associate degree or bachelor’s degree in medical bill coding/health information, nursing, or similar field preferred; in lieu of a formal degree, two or more years of technical training or work experience in a medical coding, medical billing, or insurance environment is accepted.
• One or more years’ experience working in a customer facing environment highly desirable; experience working in a medical clinic or insurance environment is a plus.
• Medical coding certification is preferred, or willing to obtain certification with 18 months of employment.

To be considered for a higher level, the following requirements are needed as well as the aforementioned requirements :

• Associate’s degree or Bachelor’s degree in Medical Coding/Health Information, Nursing, or similar field preferred; in lieu of a degree, two or more years of technical training or work experience in a medical coding, medical billing or insurance environment is accepted.
• Certification from either American Academy of Professional Coders (AAPC) or America Health Information Management Association (AHIMA).

• Knowledge of workers’ compensation insurance and/ or medical coding experience preferred.
• Experience in Mitchell Software is a plus.
• Ability to understand and use analytical skills relating to business interpretation of medical documents, including CPT, ICD, HCPS, CMS and bundling.
• Basic math skills and is good with numbers.
• Strong attention to detail.
• Strong oral and written communication skills.
• Proficient in MS Office software applications (Excel, Word, etc.).
• Effective organizational and time management skills.
• Ability to work in a fast-paced production-oriented environment.
• Must be willing to obtain medical coding certification or have certification. 

The base pay posted is just one component of SFM’s total compensation package. The salary range listed represents the full compensation range for this position. Job title and starting pay will be based on the selected candidate’s relevant knowledge, skills, abilities and/or experience, and education, if applicable as well as internal equity with other employees in the same job classification.

Work Environment and Physical Demands :

Regular attendance is required. Work takes place in a semi paperless environment within an office setting or home office, using standard office equipment such as computers, phones, and photocopiers, which requires being stationary for extended periods of time. While performing the duties of this job, the employee is regularly required to talk or hear, and maintain concentration and focus. The employee frequently is required to stand; walk; use hands and fingers, handle or feel; and reach with hands and arms and work with close vision. This position requires the ability to occasionally lift office products and supplies, up to 20 pounds. Work is performed indoors with little to no exposure to extreme outdoor weather conditions.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

About SFM

Since 1983, our mission has been to be the workers’ compensation partner of choice for agents, employers and their workers. In that time, we’ve expanded to a little over 22,000 customers in the Midwest and grown our offerings to include vocational rehabilitation, safe patient handling, loss prevention, medical services and more. Though much has changed through the years, our focus continues to be unrivaled customer service, safety, and providing better outcomes for employers and injured workers.

SFM is unique in that we are small enough that your voice is heard but has all the benefits and perks of a larger employer. We value your opinion, help you reach your goals, and make it easy for you to maintain work-life balance. SFM is committed to creating the best work environment and believes that our exceptional and motivated employees are our greatest strength.

Join us!! Click "Apply" Now

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SFM Mutual Insurance Company and each of its parent companies, subsidiaries and/or affiliated companies are Equal Opportunity/Affirmative Action Employers. SFM provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, status with regard to public assistance, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

  SFM Companies, EEO/AA Employers . SFM is a participant of E-Verify.  Applicants have rights under Federal Employment Laws. 

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