Job Summary:
manuals.
LEVEL OF RESPONSIBILITY
COMPETENCIES
PHYSICAL REQUIREMENTS
CERTIFICATES, LICENSES, REGISTRATIONS
OTHER REQUIREMENTS
Applies the appropriate diagnostic and procedural codes to individual patient health information for data retrieval, analysis, and claims processing.
Job Duties:
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Routine duties shall include providing health care services to individuals eligible for services in accordance with the self-governance compact and funding agreement between the Cherokee Nation and United States executed under the authority of the Indian Self-Determination and Education Assistance Act.
- Identifies and codes inpatient records for the purpose of claims processing and compliance with federal and
manuals.
- Adheres to official coding guidelines and internal policies concerning code assignments.
- Consults with physicians and other clinicians as needed to resolve coding issues.
- Analyzes, enters, and manipulates database. Confirms appropriate code assignments.
- Performs audits of medical records for completeness and accuracy.
- Relies on limited experience and judgment to plan and accomplish goals.
- Keeps abreast of coding guidelines and reimbursement reporting requirements. Brings identified concerns to supervisor or department manager for resolution.
- Maintains verifiable records at an institution or facility that has a published records retention policy that is equal to or exceeds the retention required by federal, tribal, and/or state regulations.
- Maintains the confidentiality of any information received from any person or source about a patient, unless authorized in writing by the patient or required by law or court order.
- Complies with the applicable state, tribal, and federal regulations regarding the security, safety, and confidentiality of any record created, maintained, transferred, or destroyed, whether the record is written, taped, computerized, or stored in any other medium.
- Other duties as assigned.
LEVEL OF RESPONSIBILITY
- Performs work under general supervision.
- Handles basic issues and problems, and refers more complex issues to higher-level staff.
- Possesses beginning to working knowledge of subject matter.
QUALIFICATIONS
- High school diploma or GED; no exceptions.
- Six (6) months of related experience or one (1) year of non-related experience.
COMPETENCIES
- Detail oriented.
- Ability to understand and follow directions.
- Organizational skills.
- Attentiveness.
- Clerical skills.
PHYSICAL REQUIREMENTS
While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to stand and walk. The employee must regularly lift and /or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.
CERTIFICATES, LICENSES, REGISTRATIONS
- Must possess Certified Professional Coder Apprentice (CPC-A), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), Certified Coding Specialist (CCS or CCS-P) from AAPC or the American Health Information Management Association (AHIMA).
- Must maintain certification throughout employment.
OTHER REQUIREMENTS
The employee must not be and will not be under sanction by the United States Department of Health and Human Services Office of the Inspector General (OIG) or by the General Services Administration (GSA) or listed on the OIG's Cumulative Sanction Report, or the GSA's List of Excluded Providers, or listed on the OIG's List of Excluded Individuals/Entities (LEIE).
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