Program: Wind River Family & Community Healthcare
Opening Date: December 30, 2020
Closing Date: January 13, 2021
Hours: Generally Monday-Friday, 40 Hour Work Week
The purpose of this position is to be performing a full range of administrative duties in accordance with established Wind River Family and Community Health Care policies, procedures, and methods. This position reports directly to the Health Information Manager.
Performs highly technical and specialized functions for the Wind River Family & Community Health Care. 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, CPT and HCPCS coding for reimbursement. The coding function ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.
The incumbent assigns and sequences ICD-10/CPT/HCPCS codes to diagnoses and procedures for documented information. Assures the final diagnoses and operative procedures as stated by the physician are valid and complete. Abstracts all necessary information from health records to identify secondary complications and comorbid 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 incumbent determines the final diagnoses and procedures stated by the physician or other health care providers are valid and complete.
Quantitative analysis – 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.
Qualitative analysis – 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) levels are assigned using the correct CPT code.
Other duties as assigned.
AAPC and/or AHIMA
CCS, CCS-P or CPC
Education and Experience:
Minimum of (1) year of experience in medical billing office in a healthcare setting, which demonstrates expert knowledge of established professional medical billing processes, procedures and protocols, along with any supporting certifications such as BLS and other necessary competencies (e.g., ACLS, TNCC, PALS, etc.).
The work environment involves risks and discomforts of a patient care setting including exposure to communicable diseases, working with office machines, and computers. The demand of computer terminals and keyboards for long periods of time that may cause eye, shoulder, and wrist strain. Work is performed in a smoke-free office setting. There is adequate light, heat, and ventilation in the work area.
The incumbent must maintain strict confidentiality and high ethical standards in performing the position. The incumbent needs to be respectful, possess cultural awareness and sensitivity, be flexible, and demonstrate sound work ethics.
How to Apply: