Certified Medical Coder

Great Plains Tribal Leaders Health • Rapid City, SD

8d • $25 - $32 • Onsite

About The Position

The Certified Medical Coder will support the Oyate Health Center (OHC) Patient Accounts Department. This role is responsible for converting medical diagnoses, supplies, and processes into standardized codes for insurance claims, ensuring compliance with Medicare, Medicaid, and private insurance rules and regulations. The incumbent works independently, communicates with Providers and Billing staff on coding/documentation issues, and participates on performance improvement teams and other committees as assigned. This position requires adherence to federal laws and regulations as required by HIPAA, accurate and timely performance of core responsibilities, regular attendance, effective communication, and utilization of required systems and tools.

Requirements

• 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.
• 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.
• Must comply with federal laws and regulations as required by the Health Insurance Portability and Accountability Act (HIPAA).
• Requires the ability to perform the essential functions of the job, with or without reasonable accommodation.
• Requires the ability to sit for extended periods and regularly use standard office equipment such as a computer, keyboard, telephone, and copier.
• Ability to lift and carry office materials or supplies up to 25 pounds occasionally.
• Requires manual dexterity and visual acuity for computer use and document review.
• Must be able to read, write, speak, and hear.

Nice To Haves

• 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.

Responsibilities

• 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 comorbidity 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.
• 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.
• Performs the core responsibilities of the position accurately, timely, and in accordance with established standards.
• Maintains regular and reliable attendance consistent with the position’s schedule and operational needs.
• Communicates effectively with internal and external stakeholders as required by the role.
• Adheres to all applicable policies, procedures, and regulatory requirements.
• Utilizes required systems, tools, and technology necessary to perform the job.

Benefits

• Compliance with our Employee Health Procedure is a condition of employment. You are required to agree that you will comply with all job-related employee health screening and immunizations prior to your first day of employment. Jobs require that you have documentation that you have completed the following immunizations prior to your first day of employment: MMR (Measles, Mumps and Rubella, Varicella (Chicken Pox), Hepatitis B, Influenza, T-dap (Tetanus - Diphtheria - Pertussis), and COVID-19 vaccination is required.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree