Medical Coder - Chumash Enterprises

Overview:

At the direction of Billing Supevisor, performs all data entry and Medical/Dental Coder duties as needed to effectively meet IHS, AAAHC, CPC, and ICD-10 coding guidelines and certification requirements.

Responsibilities:

• Analyzes all medical/dental records to determine the completeness of records in compliance with auditing requirements.  Verifies presence of all necessary reports, forms, and appropriate signatures.  Enumerate and substantiate all diagnosis, treatment, and therapy.
• Compare Super-bill and chart notes to ensure the consistency of records that includes references to several diseases, and various medical, diagnostic, therapeutic and surgical procedures. Identifies inconsistencies or discrepancies among medical documentation and discusses with the appropriate staff member.
• Physicians are required to enter a visit code at the end of each visit.  The Certified Professional Coder may adjust or document codes by determining and sequencing codes to reflect the resources used in the care of patients, as allowed by certified standards under supervision of Billing Manager.
• Enters necessary information from physician’s records, records into NextGen. Provides accurate data entry for both medical and dental departments daily.
• Ensures that Current Procedural Terminology (CPT) coding is current and input correctly into NextGen. Informs billing supervisor of any discrepancies.
• Ensures that International Classification of Disease (ICD-10-CM) coding is current and input into NextGen correctly.
• Maintains the confidentiality and security of all medical records in accordance with the Privacy Act, AAAHC and IHS policies and procedures.
• Monitors and records discrepancies from physician record review and informs provider if a correction is needed.
• Assists Audit Team with compiling and retrieving records data for audits, performance improvement studies, research, patient care evaluation activities, reports, and compliance.
• Initiates and participates in the updating of Super-bills and assists with staff training annually, incorporating changes in, ICD- 10-CM, CPT and HCPCS codes.  
• Provides consultation to Department heads and Super Committee regarding coding and compliance issues. 
• Assists with working the A/R monthly on unpaid claims.
• Assist with special projects as assigned by the Billing Manager or Financial Services Director.
• Upholds a work environment that promotes teamwork, partnership, recognition, mutual respect, collaboration, while role modeling the company values, behaviors, and culture of One.Team.Chumash.
• Performs other duties as assigned.

Qualifications:

• High School Diploma or GED Certificate.
• Associates degree in a related field preferred or equivalent work experience.
• Education with an AA medical billing and coding class certification or equivalent training.
• Obtain and keep current CPC Certification.
• Knowledge of medical terminology and usage’s, covering the full range of general medical, minor surgical, pharmaceutical, medical abstracts and abbreviations. 
• Practical knowledge of well-established medical records procedures, regulation, and principles to carry out a variety of medical records functions such as analysis, coding, quality assurance and compiling data. 
• Practical knowledge of well-established medical records procedures, regulation, and principles to carry out a variety of medical records functions such as analysis, coding, quality assurance and compiling data. 
• Knowledge ICD-10-CM, CPT-4, HCPCS, coding nomenclature and Medicare Compliance Regulations.
• Knowledge of medical records confidentiality and security, e.g., Privacy Act of 1994,
• Release of Medical Information and Freedom of Information Act.
• Knowledge of classification systems to code diagnostic and operative/procedural information using various classification methods.
• Knowledge of physiology, major anatomical systems, and related disease processes.
• Ability to read, analyze, and interpret program forms, grants, and documents.
• Intermediate computer proficiency utilizing Microsoft applications, e-mail, and internet and EHR systems.
• Native American hiring preference applies.
• Customer Focus Knowing the (internal and external) customer business needs and acting accordingly; anticipating customer needs, and giving high priority to customer satisfaction and customer service.
• Planning and Organizing Setting priorities and defining actions, time, and resources needed to achieve predefined goals.
• Teamwork Working as a productive member of a cohesive group toward a common goal and contributing to team development and effective team dynamics.
• Accountability Accepting responsibility that results in anticipation/prevention of problem areas from actions, and problem solving inside and outside the department/organization.
• Written Communication Expressing ideas and opinions clearly in properly structured, well organized, and grammatically correct reports or documents; utilizing language and terminology that is understandable for the reader.
• Oral Communication Shaping and expressing ideas and information in an effective manner.

Location:90 Via Juana DriveMinimum Pay Rate:$25.23 per hourMaximum Pay Rate:$29.68 per hour