BAD RIVE BAND OF LAKE SUPERIOR

TRIBE OF CHIPPEWA INDIANS

CHIEF BLACKBIRD CENTER                                        P.O. BOX 39                                                 ODANAH, WI 54861

Job Title:                                Certified Medical Coder

Department:                          Clinic

Hourly Rate:                         $16.00 - $18.00/hr DOQ           Full Time – 40 Hours

Exempt:                                 No/Hourly

Supervisor:                            PRC Manager

Summary: The Certified Medical Coder reviews, analyzes and codes diagnostic and procedural information that determines Medicare, Medicaid and private insurance payments. The primary function is to perform ICD-10-CM, CPT and HCPCS coding for reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.

 

Essential Duties and Responsibilities include the following.

 

Assigns and sequences ICD-10-CM/CPT/HCPCS codes to diagnoses and procedures for documented information. Assures the final diagnoses and procedures as stated by the physician are valid and complete. Abstracts all necessary information from health 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.

The coder determines the final diagnoses and procedures stated by the physician or other health care providers are valid and complete.

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.

Analyzes provider documentation to assure the appropriate Evaluation & Management (E/ M) services are accounted for using the correct CPT code.

Performs all other duties as assigned by the PRC manager or clinic administrator to support billing, health record management and data collection.

Ability to use electronic health record proficiently and makes recommendations for improved documentation as needed.

Ability to use RPMS system proficiently and retrieve coding data as needed for auditing and QA purposes.

Maintain confidentiality with strict adherence to tribal and HIPAA policies.

 

Qualification Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skills, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

Education and/or Experience Required:

  • Active certification from American Association of Certified Coders (AAPC) and/or coder certification from a medical coding program.
  • Experience with an electronic health record and RPMS system strongly recommended.
  • Advance knowledge of medical codes involving selections of most accurate and description code using the ICD-10-CM, Volumes 1- 3, CPT, HCPCS, and IHS coding conventions.
  • 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.
  • This is a required driver position.
  • Effective communication skills and ability to work well with others.
  • Excellent computer skills.
  • Knowledge of health insurance processes, policies, Medicare and Medicaid.

Background Check:

This position is contingent on ability to pass background check required. This position required for eligibility a required driver check, to meet eligibility for tribal insurance. Caregiver background check is also required when working with children and/or elderly.

 

Physical Demands: The physical demands described here are representative of those that must meet by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Must be physical able to perform all job duties. Walking, standing, bending, stooping and occasional lifting up to 25lbs and/or carrying for short distances.

 

Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

This position is subject to inside and outside work. The noise level may be moderate to loud.

 

Drug-Free Workplace in accordance with the Drug Free Workplace Act of 1988, P.L. 100-690 and the Bad River Tribe’s Employee Policy & Procedures Handbook. Indian Preference will be given in accordance with P.L. 93-638 and the Tribe’s Preference Policy.

A complete application will include Transcripts (unofficial or official), certificates, resume and a tribal application. No incomplete application will not be considered.

 

Public:

Opens: June 19th

Closes: Open Until Filled

                                                                                                                                                Send Application and Resume To:

                                                                                                                                                                Bad River Tribe

                                                                                                                                                               Human Resource Office

                                                                                                                                                                P.O. Box 39

                                                                                                                                                                Odanah, WI 54861

                                                                                                                                                                www.badriver-nsn.gov