Alaska Native Tribal Health Consortium has a hiring preference for qualified Alaska Native and American Indian applicants pursuant to P.L. 93-638 Indian Self Determination Act.

Summary:

Under limited supervision, performs coding on all diagnoses, procedures, professional services, and supplies. Uses the most accurate codes for reimbursement purposes, research, epidemiology, statistical analysis outcomes, fi nancial and strategic planning, evaluation of quality of care, and communication to support the patient’s treatment. Maintains the confidentiality of patient records and procedures.

Responsibilities:

Responsible for abstracting, coding, and sequencing the classification of medical and surgical procedures, professional services, diagnosis, supplies and treatment modalities. Selects the most accurate and descriptive codes from the listings of American Medical Association Current Procedural Terminology (CPT-4) Coding system, International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM); and Healthcare Common Procedure Coding System (HCPCS). Assigns Diagnosis-Related Groups (DRGs) and performs coding compliance reviews. Abstracts and codes pertinent medical data into multiple software programs.

Follows official coding guidelines to review and analyze medical records. Extracts pertinent data from the patient’s health record, and determines appropriate coding for clinic reports and billing documents. Identifies codes for reporting medical services, supplies and procedures performed by physicians, and enters codes into computer system. Provides feedback and education to physician and professional staff regarding changes in coding methodology and enhanced documentation procedures for optimizing reimbursement. Sends coding queries to providers to request missing information.

Follows data entry procedures, logs patient records into computer system to assure accurate processing of information to track and report the information and optimize reimbursement. Reviews computer record for accuracy. Maintains manual and electronic filing systems. Retrieves, reviews and compiles data for reports as directed. Reviews patient database to monitor records and clarify and resolve discrepancies.

Reviews and analyzes medical records to assure the record is complete and accurate, includes signatures and supporting documentation, and meets the requirements for accrediting agencies and reimbursement agencies.

Provides training and mentoring to new employees/coders as needed and provides technical advice for situations requiring higher-level expertise. Performs routine audits independently and participates in performance improvement activities. Provides reports of findings and feedback to parties involved. Maintains the confidentiality of patient records and procedures.