Certified Coder

Cherokee Indian Hospital Authority•Cherokee, NC

16h•Onsite

About The Position

The incumbent performs highly technical and specialized functions for the Cherokee Indian Hospital Authority. The employee reviews, analyzes, 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 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. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.

Requirements

RHIA, RHIT or CCS, CCS-P or CPC certification is required.
Must have a minimal of one year medical coding experience.
The incumbent is expected to enroll in continuing education courses to maintain certification.
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.
Advance knowledge of medical codes involving selections of most accurate code using the ICD-10-CM, Volumes 1-3, CPT, HCPCS, and official coding guidelines.
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.
Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes.
Must have good math skills and effective communication skills.
Must be knowledgeable of the fiscal requirements, policies, and procedures of federal, state, and tribal programs.
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, typewriter, calculator, facsimile, copy machine, and other office equipment as required.
Must be able to follow instructions and work independently.
Must possess a valid North Carolina driver’s license.
Close attention to detail and mental concentration for extended periods of time are required with systems problems and applications.
Subject to frequent interruptions requiring varied responses.
Must deal with multiple situations concurrently.
Physical efforts require mobility, reaching, bending, manual dexterity, and visual acuity, and the ability to lift at least 15 pounds.

Nice To Haves

Six to twelve months would be required to become proficient in most phases of the job.

Responsibilities

Assigns and sequences ICD-10-CM/CPT/HCPCS codes to diagnosis and procedure for documented information.
Assures the final diagnosis and operative procedures as stated by the physician are valid and complete.
Abstracts all necessary information from the medical 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.
Determines the final diagnosis and procedures stated by the physician or other health care providers are valid and complete.
Analyzes provider documentation to assure the appropriate Evaluation & Management (E&M) levels are assigned using the correct CPT code.
Operates RPMS and EHR peripheral equipment (CRT and printer) for the purpose of key-entering data for the process of updating patient information files and of exporting said data to the Nashville Area Office.
Performs all duties according to established safety procedures and tribal policy.
Performs other duties assigned.
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.
Consistently demonstrates superior customer service skills to patients/customers by demonstrating characteristics that align with CIHA’s guiding principles and core values. Ensure excellent customer service is provided to all patients/customers by seeking out opportunities to be of service.