Certified Medical Coder at Great Plains Tribal Leaders Health Board Inc

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Full Time

Start Date

Immediate

Expiry Date

06 Feb, 26

Salary

0.0

Posted On

08 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Coding, ICD-10, CPT 4, HCPCS, HIPAA Compliance, Health Records Management, Analytical Skills, Problem-Solving, Communication Skills, Interpersonal Skills, Decision-Making, Project Management, Attention to Detail, Documentation, Regulatory Knowledge, Safety Compliance

Industry

Public Health

Description

Job Summary: Primary responsibilities of the certified medical coder duties in support of the Oyate Health Center (OHC) Patient Accounts Department, facilitating and is responsible for converting medical diagnosis, supplies and processes into standardized codes that are used when filing insurance claims, to ensure compliance with Medicare, Medicaid, and private insurance rules and regulations. Essential Functions: * Knowledge of Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health Act (HITECH). * Knowledge of medical records requirements and functions. * Knowledge of ICD-10 (International Classification of Diseases), CPT 4 (Current Procedural Technology) and HCPCS (Healthcare Common Procedure Coding System) coding guidelines. * Analyzes and abstracts all necessary information from the record to reflect secondary complications and co-morbidity conditions. * Codes diagnosis and/or procedures from the medical records, and assures the final diagnosis and procedures as stated by the medical provider are valid and complete. * Codes complex and difficult records accurately; makes complete and accurate selection of the principal diagnosis and principal procedure/operation; diagnosis codes are sequenced properly; and assures that all orders (medication, lab, and radiology) have been documented properly to support level of services and reflect the medical necessity for the order. * Assures the presence of all components of the record, including correct identification, health record number, signatures, dates, accurate and complete notes (chief complaint, history of present illness (HPI), review of systems, examination, and assessment and plan are completely documented. * Analyzes and abstracts all necessary information from the record to reflect secondary complications and co-morbidity conditions. * Codes diagnosis and/or procedures from the medical records, and assures the final diagnosis and procedures as stated by the medical provider are valid and complete. * Codes complex and difficult records accurately; makes complete and accurate selection of the principal diagnosis and principal procedure/operation; diagnosis codes are sequenced properly; and assures that all orders (medication, lab, and radiology) have been documented properly to support level of services and reflect the medical necessity for the order. * Assures the presence of all components of the record, including correct identification, health record number, signatures, dates, accurate and complete notes (chief complaint, history of present illness (HPI), review of systems, examination, and assessment and plan are completely documented. * Examines the level of services to ensure it is accurate and appropriate for the documentation in the note and when appropriate modify level of service. * Completes medical record by reviewing information; notifying health care providers of record deficiencies; tracking outstanding records; and resolves medical record discrepancies by collecting and analyzing information. * Incumbent works independently. Takes the initiative to communicate with Providers and Billing staff on coding/documentation issues. * Participates on performance improvement teams and other committees as assigned. * Must comply with federal laws and regulations as required by the Health Insurance Portability and Accountability Act (HIPAA). * Performs related duties. Requirements * Knowledge of federal, state, and local regulations affecting areas of responsibility. * Knowledge of occupational health, safety and environmental compliance program management principles. * Knowledge of industrial hygiene, environmental and safety engineering, and fire protection. * Knowledge of local, state and federal occupational safety and health regulations. * Knowledge of job hazard analysis and other analytical techniques. * Knowledge of accident prevention principles. * Knowledge of safety inspection principles. * Knowledge of computers and job-related software programs. * Skill in decision-making and problem-solving. * Skill in managing multiple projects. * Skills in oral and written communication. * Skill in prioritizing and planning. * Skill in interpersonal relations. * Skill in the use of such office equipment as a computer, scanner, fax machine, and copier. Minimum Qualifications Education/Relevant Experience: Completion of a formal training program or an associate’s degree and one (1) year of relevant experience; or a high school diploma or GED and three (3) years of relevant experience. Certification: Certified Medical Coding Certification Individuals must have applicable education or experience applying a body of standardized rules, procedures, or operations to perform the full range of standard clerical assignments and resolve recurring problems or to operate and adjust varied equipment for purposes such as performing numerous standardized tests or operations. The GPTLHB is a tribal organization that follows tribal preference laws. Our policy is to give preference to qualified Indian/Tribal candidates overqualified non-native candidates in hiring decisions if all other qualifications are equal. Employment is contingent upon the outcome of all required criminal background checks and pre-employment drug screen.

Responsibilities

The certified medical coder is responsible for converting medical diagnoses, supplies, and processes into standardized codes for insurance claims. This role ensures compliance with Medicare, Medicaid, and private insurance regulations while analyzing and abstracting necessary information from medical records.