HIM CODER (OTPT)

Fort Defiance Indian Hospital Board, Inc.; Arizona; Hybrid; USD 36,000 - 44,000; Full time

Job summary

Fort Defiance Indian Hospital Board, Inc. is seeking an experienced outpatient coder to review patient records and assign accurate ICD-10-CM/PCS, CPT, and HCPCS codes.

You will work with the RPMS system, audit documentation, and ensure data integrity while maintaining patient confidentiality. Required qualifications include RHIT or AHIMA/AAPC certifications and a high school diploma; outpatient coding experience is strongly preferred.

Qualifications

• Two (2) years of outpatient coding experience in a healthcare setting or RHIT certification.
• AHIMA or AAPC Certified Coding Specialist certifications strongly recommended.
• High School Diploma or GED as minimum education; coding certifications preferred.

Responsibilities

• Retrieves information from RPMS and reviews medical records to ensure correct diagnosis and coding.
• Assigns and codes using ICD-10-CM/PCS, CPT, HCPCS per guidelines and CMS policies.
• Performs quality data entry into RPMS and 3M Grouper; audits and reviews for accuracy and completeness.
• Maintains confidentiality and protects patient information under HIPAA and related regulations.

Education

RHIT Certification

AHIMA Coding Certification (CCC/CCS/CCS-P/CPC/etc)

High School Diploma or GED

Job description

Fort Defiance
Fort Defiance, AZ 86504, USA

Description

Salary Range: $26.13/hr. - $32.14/hr.

**APPLICANT MUST HAVE A VALID, UNRESTRICTED INSURABLE DRIVER’S LICENSE**

**RESUMES AND REFERENCES ARE REQUIRED**

ESSENTIAL DUTIES, FUNCTIONS AND RESPONSIBILITIES

• Retrieves information from the RPMS in identifying the patients; and reviews medical records to insure FDIHB providers assign the correct diagnosis and procedural codes.
• Assigns and categorizes codes using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), International Classification of Diseases, Tenth Revision, Procedural Coding System (ICD-10-PCS), Current Procedure Terminology (CPT), Health Common Procedure Coding System (HCPCS) Code, coding guidelines and other policies set by FDIHB, Centers for Medicare and Medicaid Services (CMS) or other regulatory organizations as related. Uses the 3M Grouper System to assist in classifying diagnoses and verifying the accuracy of coding assignments.
• Abstracts all necessary information by auditing and analyzing patient care component forms (PCC), Electronic Health record for the appropriate Evaluation and Management (E&M) levels, CPT and the HCPCS codes that accurately describe each medical/surgical procedures/supplies on each patient visit.
• Performs quantitative analysis to ensure the presence of all component parts of the record such as patient name medical record number, dates of service and time, signatures where required on paper forms and/or E.H.R. and the presence of all reports, which are indicated by the nature of the visit. Evaluates the records for internal consistency, completeness and accuracy for sufficient data to justify the diagnoses and procedures assigned. Identifies inconsistencies or discrepancies among medical documentation and discuss with appropriate staff members and physicians without infringing on decisions concerning a medical provider or physician’s clinical judgment.
• Performs quality data entry of protected patient health information into the RPMS and 3M Grouper systems, which requires extensive interaction with the RPMS-PCC system using mnemonics for entering and editing data. Performs audits and medical reviews by running error listings and/or other data reports to ensure documentation and accountability of all data. Reviews and completes zero reports where PCC plus System is in place, RPMS Audit list reporting to capture all data missed and/or errors hanging in the system in a timely manner.
• Ensures the validity, completion and disposition of all clinical records briefs reflecting encoded and other patient related information. Maintains confidentiality of health information in accordance with the Privacy Act of 1974 and the HIPAA of 1996, Alcohol and Drug Abuse Patient Records, Freedom of Information Act and other mandatory federal regulations.
• Works with clinical staff in coordinating the workflow such as PCC+ system and ensuring up-to-date codes are maintained in the RPMS, and by surveying potential risk areas and identifying inconsistencies or discrepancies within the medical records and discusses with the appropriate medical, nursing, and/or healthcare providers for corrective action without infringing on decisions concerning a physician’s clinical judgment.
• Monitors specific areas as indicated for areas of improvement by recognizing potential risks subjected to compliance issues such as coding and data entry. Incumbent documents findings prepares reports to present to immediate supervisor. Performs quality assurance/performance functions for the department to ensure qualities of services are provided. Prepares reports, presents to staff and Quality Assurance Committee as needed.
• Completes all RCM Queries within 24 hours upon receipt.
• Uses coding guidelines and resources that include the Encoder (3M), ICD-10 CM, ICD 10-PCS, CPT, HCPCS, and other coding classification systems, RPMS user’s guide, PDR, the Privacy Act, HIPPA regulations, medical dictionaries, TMS policies and procedures, JCAHO/CMS, the Revenue Cycle Management Compliance Plan, Health Records guidelines, written and oral policies and procedures.
• Conducts quality control and improvement reviews by; tracking and identifying inadequate documentation for coding; communication program software and hardware problems; and by maintaining a deficiency and productivity logs. Works with clinical providers on clinical documentation improvement and coordinates with providers to correct deficiencies identified for processing of coding visits.
• Maintains the integrity of patient information; including but not limited to, protecting from any unauthorized disclosures, breaches, or altering/destroying of patient information.
• Complies with FDIHB policies governing user access of accounts to complete daily work duties; and ensures confidentiality in accordance with the Privacy Act of 1974, Alcohol and Drug Abuse Patient Records, Freedom of Information Act, HIPAA and other pertinent federal regulations. Reports any security breaches or potential breaches to the immediate supervisor.
• Keeps abreast of the latest and new concepts and techniques in coding, regulations and related resources pertaining to diagnostic and procedure codes. Continues pursuit and development of job related individual interests and specialty areas for both personal growth and program and services enhancement.
• Performs other duties as assigned.

MANDATORY MINIMUM QUALIFICATIONS

Experience:

Two (2) years of outpatient coding experience in a healthcare setting. If no outpatient coding experience, must have a Registered Health Information Technician (RHIT) Certification. Or Completion Certificate from a University/College or Technical school related to Medical Billing and Coding course. Must have certification within one (1) year.

Education:

• High School Diploma or Equivalency (HSE).
• Coding Certification by the American Health Information Management Association (AHIMA) or, the American Academy of Professional Coders (AAPC), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Certified Coding Specialist Physician-based (CCS-P) or Coding Certification by the American Academy of Professional Coders (AAPC), Certified Professional Coder (CPC), Certified Professional Coder – Apprentice (CPC-A), Certified Outpatient Coding (COC), Certified Inpatient Coder (CIC).

FDIHB and its facilities are located within the Navajo Nation and, in accordance with Navajo Nation law, has implemented a Navajo/Indian Preference in Employment Policy. Pursuant to this Policy, applicants who meet the minimum qualifications for this position and who are enrolled members of the Navajo Nation will be given primary preference in hiring and employment for this position and members of other federally recognized Indian tribes will be given secondary preference. Other candidates will be considered only after all candidates entitled to primary or secondary preference have been fully considered.

Qualifications

Education

Required

High School Diploma/GED or better.

Experience

Required

2 years:

Two (2) years of outpatient coding experience in a healthcare setting. If no outpatient codingexperience, must have a Registered Health Information Technician (RHIT) Certification. OrCompletion Certificate from a University/College or Technical school related to Medical Billingand Coding course. Must have certification within one (1) year

Licenses & Certifications

Preferred

Certified Coding Assoc.

Certified Coding Spec.

Certified Inpt. Coder

Certified Outpt. Coding

Certified Prof Coder

Cert Prof Cod Apprentice

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.