Certified Medical Coder
Any individual who receives an offer of employment or will receive a payroll check are required to submit to a drug and alcohol test as a condition of obtaining employment.
Mille Lacs Band Member/American Indian preference applies
The Certified Medical Coder performs highly technical and specialized functions for health and Humans Services. The coder will review, analyze and codes diagnostic and procedural information that determines Medicare, Medicaid and Private Insurance Payments. The primary function of this position is to perform ICD-10-CM, CPT and HCPCS coding for reimbursement. The coding function ensures compliance with established guidelines, third party reimbursement policies, and state and federal regulation and accreditation guidelines.
• CPC, CCS, CCS-P certification is required.
• Associates degree in business, finance, medical or related field is preferred.
• RHIT certification, is preferred.
• One to three years of experience in health record management, procedure and diagnosis coding.
• Advanced knowledge of medical terminology, abbreviations, procedures, anatomy, physiology, disease processes, pharmacology and metric system to identify specific clinical findings, to support existing diagnosis.
• Advanced knowledge of medical codes
• Skill in correlating generalized observations and/or symptoms to a stated diagnosis to apply the correct ICD-10-CM code.
• Advanced knowledge of medical codes that involve the selection of the most accurate and descriptive code for billing of third-party resources.
• Extensive knowledge of official coding conventions and rules as established by the American Medical Association and the Center for Medicare and Medicaid Services
• Knowledge of Electronic Health Record for the ability to analyze encounters and notify providers of any data that needs corrections through EHR broadcast, notifications and templates
• Must have good math skills and effective communication skills
• Knowledge of HIPAA, Affordable Care Act, Insurance Requirements and all federal regulations as it pertains to the electronic health record
• Knowledge of current and developing issues and trends in electronic health records
• Ability to gather data, compile information and prepare reports
• Excellent organizational and communication skills, both verbal and written
• Ability to work under pressure in a fast paced environment, multi task and prioritize
• Knowledge and sensitivity to Native American Culture
• Performs other duties as assigned by the Revenue Cycle Manager
• Must pass a background check.
• Must pass a Pre-employment drug & alcohol test.
DUTIES AND RESPONSIBILITIES:
• Assigns and sequences ICD-10-CM/CPT/HCPCS codes to the diagnoses and procedures for all documented information.
• Assures the final diagnoses and procedures state are valid and complete
• Abstracts all necessary information from health records to identify any additional complications
• Reviews all necessary information and assigns the applicable ICD-10- CM/CPT/HCPCS, which most accurately describes the diagnoses, procedure or therapy according to established rules and regulations
• Provides quantitative analysis by performing a comprehensive review of the record to assure that all of the required documentation is present, which includes, but is not limited to the patient and record identification, signatures and dates, and all other necessary data to support the treatment rendered
• Provides qualitative analysis to evaluate the record for proper documentation, consistency and adequacy. Ensures that the final diagnosis accurately reflects the care and treatment rendered.
• Reviews the records for compliance as established with third party reimbursement and screening criteria
• Nature of work is such that incumbent experiences infrequent periods of modest stress levels due to workload
• Work is exclusively indoors in a controlled climate area
• Little threat of personal danger or risk
• Hours are typically 8-5, but possibly with some extra hours. May involve some evening or weekend work
• Some local travel may be required.