Certified Medical Coder (2)

Summary:

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Summary: The Certified Medical Coder reviews, analyzes and codes diagnostic and procedural information that determines Medicare, Medicaid and private insurance payments. The primary function is to perform ICD-10-CM, CPT and HCPCS coding for reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.

Job Announcement Flyer:

Certified-Medical-Coder-03.17.25.pdf [pdf - 187.46 KB]

Duties:

Essential Duties and Responsibilities include the following. • Assigns and sequences ICD-10-CM/CPT/HCPCS codes to diagnoses and procedures for documented information. Assures the final diagnoses and procedures as stated by the physician are valid and complete. Abstracts all necessary information from health records to identify secondary complications and co-morbid conditions. • Abstracts all necessary information and assigns codes (ICD-10, CPT & HCPCS), which most accurately describe each documented diagnosis, surgical procedure and special therapy or procedure according to established guidelines. • The coder determines the final diagnoses and procedures stated by the physician or other health care providers are valid and complete. • Performs a comprehensive review for the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered. • Evaluates the record for documentation consistency and adequacy. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established third-party reimbursement agencies and special screening criteria. • Analyzes provider documentation to assure the appropriate Evaluation & Management (E/ M) services are accounted for using the correct CPT code. • Performs all other duties as assigned by the PRC manager or clinic administrator to support billing, health record management and data collection. • Ability to use electronic health record (Intergy) proficiently and makes recommendations for improved documentation as needed. • Maintain confidentiality with strict adherence to tribal and HIPAA policies.

Qualifications:

Qualification Requirements: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skills, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: Required: • Active certification from American Association of Certified Coders (AAPC) and/or coder certification from a medical coding program. • Experience with an electronic health record. • Advance knowledge of medical codes involving selections of most accurate and description code using the ICD-10-CM, Volumes 1- 3, CPT, HCPCS, and IHS coding conventions. • Skill in correlating generalized observations/symptoms (vital signs, lab results, medications, etc.) to a stated diagnosis to assign the correct ICD-10-CM code. • Advance knowledge of medical codes involving selection of most accurate and descriptive code using the CPT codes for billing of third party resources. Other Skills and Abilities: Required: • This is a required driver position. • Effective communication skills and ability to work well with others. • Excellent computer skills. • Knowledge of health insurance processes, policies, Medicare and Medicaid.

Work Type:

Permanent, Full

Announcement #:

Certified Medical Coder (2)

Who May Apply?

US Citizens