Medical Coder

POSITION DESCRIPTION

This incumbent performs highly technical and specialized functions. The employee reviews, analyzes, and codes diagnostic and procedural information to ensure compliance with established coding guidelines, third party reimbursement policies and regulations. The coding function is a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement.

ESSENTIAL DUTIES & RESPONSIBILITIES

· Responsible for reviewing patient charts and entering pertinent patient data into RPMS database.

· Compiles, sorts and verifies accuracy of data entered into the Electronic Health Record.

· Assigns and sequences ICD-10-CM/PCS/CPT/HCPCS codes to diagnoses and procedures for documented information.

· Assures the final diagnoses and operative procedures as stated by the provider(s) are valid and complete.

· Abstracts all necessary information from health records to identify secondary complications and co-morbid conditions.

· Quantitative analysis – 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.

· Qualitative analysis – Evaluates the record for documentation consistency and adequacy.

· Ensures that the final diagnosis accurately reflects the care and treatment rendered.

· Analyzes provider documentation to assure the appropriate Evaluation & Management (E & M) levels are assigned using the correct CPT code.

· Audits each visit to ensure all GPRA information is captured and recorded appropriately.

· Compiles data from client records for periodic inquiries and statistical reports; corrects daily census report if necessary

· Performs other job-related duties as assigned by the CFO.

REQUIRED EDUCATION, EXPERIENCE, CERTIFICATIONS AND LICENSES:

· High school diploma or GED.

· Two years of coding experience using ICD-10-CM/PCS, CPT, HCPCS, and IHS coding conventions or equivalency.

· A working knowledge of the medical and dental insurance industries, and accounting procedures and regulations.

· Advance knowledge of medical terminology, abbreviations, techniques and surgical procedures; anatomy and physiology; major disease processes; pharmacology; and the metric system to identify specific clinical findings, to support existing diagnoses, or substantiate listing additional diagnoses in the medical record.

· Requires the knowledge of the business use of computer hardware and software to ensure the effectiveness and quality of the processing and presentation of data.

· Requires skill in the use of a wide variety of office equipment including: computer, calculator, facsimile, copy machine, and other office equipment as required.

· Must be able to follow instructions and work independently.

· Must have a good understanding and ability to work with the Indian communities and overall TIHP staff.

· Must be sensitive and possess an awareness and keen appreciation of Indian traditions, customs, and socioeconomic needs of the Indian community.

· Cardiopulmonary resuscitation (CPR) certified or obtain within three months of hire.

PREFERRED EDUCATION, EXPERIENCE, CERTIFICATIONS AND LICENSES:

· Bi-Lingual/Spanish Speaking

· CCS, CCS-P or CPC certification is preferred.

PHYSICAL DEMANDS:

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. Sitting / Mobility: Approximately 80% of time is spent working at a desk. Balance of time (approximately 20%) is spent moving around work areas. Communication: Ability to effectively communicate with co-workers, patients, members of outside agencies, in person, by telephone, and by email. Vision: Ability to effectively use a computer screen and interpret printed materials, memos, and other appropriate paperwork. Lifting / Carrying: Ability to occasionally lift and/or move objects weighing no more than 25 pounds. Stooping / Kneeling: Ability to access files/stock supplies in low cabinets and shelves. Reaching / Handling: Ability to input information into computer systems and retrieve and work with appropriate paperwork, equipment, and supplies. Use of standard office equipment, including computer, telephone, calculator, copiers, and fax. Work is performed in an office/clinic environment; continuous contact with other staff and the public.

EMPLOYMENT INFORMATION

INDIAN PREFERENCE: Preference may be given to qualified Native American Indians according to the Indian Preference Hiring Act, CFR 25 USC 472. Other than Toiyabe Indian Health Project, Inc. adheres to all provisions of the Equal Employment Opportunities Act.

EQUAL OPPORTUNITY EMPLOYER: TIHP does not discriminate on the basis of race, color, national original, sex, religious preference, age, handicap, marital status, political preference, genetics or membership or non-membership in any employee organization, except as allowed by Federal and/or Tribal Law.

Pay: $54,891.20 - $73,008.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Application Question(s):

• have Advanced knowledge of medical terminology, abbreviations, techniques and surgical procedures.

Education:

• High school or equivalent (Required)

Experience:

• Medical coding: 2 years (Required)

License/Certification:

• ccs, ccs-p, cpc certification (Preferred)

Ability to Relocate:

• Bishop, CA 93514: Relocate before starting work (Required)

Work Location: In person