What are the responsibilities and job description for the Medical Coder I - Revenue Cycle - Tulsa position at Muscogee Creek Nation?
MINIMUM QUALIFICATIONS
Education – High school diploma or GED required, associate or bachelor's degree in health information management or related field preferred.
Experience – 1-2 years of experience in medical coding, with a focus on outpatient and ancillary coding preferred
Licenses & Certification – Certified Professional Coder (CPC), Certified Coding Specialist-Physician-based (CCS-P), or equivalent outpatient/ancillary certification required.
Knowledge & Skills –
Trained knowledge of medical terminology, anatomy, and physiology
Accomplished knowledge of assigning ICD-10-CM, CPT, and HCPCS coding systems
Well-versed knowledge of medical coding guidelines
Strong knowledge of Local Coverage Determination (LCD) and National Coverage Determination (NCD)
Skillful with encoding software and electronic health record (EHR) systems
Skillful with Microsoft Office Suite (Outlook, Excel, Word, etc.)
JOB SUMMARY
The purpose of this position is to accurately translate healthcare services, diagnoses, and procedures into standardized codes for billing, reimbursement, and data analysis using an international classification of disease systems. This position is for “as needed”. Incumbent reports to the Coding Supervisor/Manager regarding attendance, leave, and daily on-site/remote supervision.
WORK ENVIRONMENT
Work is performed in a normal business office environment. Potential for remote/hybrid work environment after a designated period of time and evaluation of coding accuracy and productivity. There is a moderate risk of exposure to infectious and communicable diseases, potentially hazardous chemicals, and biohazardous materials. Incumbent must be aware of all risks involved and be willing to take precautions as requested and required. Travel and occasional overtime during high-volume periods may be required.
PHYSICAL DEMANDS
Work requires the demands of normal office work in a business office as described in the work environment section above. Light lifting may be required to move files and materials to various areas within the office.
ESSENTIAL FUNCTIONS
The successful execution of the following will determine satisfactory job performance:
Coding Medical Records:
Review and analyze medical records for accurate coding of diagnoses, procedures, and services using ICD-10-CM, CPT, and HCPCS codes.
Assign appropriate codes based on coding guidelines and payer requirements.
Ensure all records are complete, compliant, and adequately documented.
Quality Assurance:
Identify and correct coding errors to maintain quality and compliance.
Work with healthcare providers to clarify information in the medical record when necessary.
Compliance and Regulation:
Stay updated with changes in coding standards, healthcare regulations, and payer policies.
Ensure compliance with HIPAA and other relevant privacy and confidentiality standards.
Claims and Reimbursement Support:
Assist with claims processing and resolving coding discrepancies that may lead to payment denials.
Collaborate with billing departments to ensure accurate reimbursement for services rendered.
Documentation Improvement:
Provide feedback to healthcare providers to improve documentation accuracy and completeness.
Participate in clinical documentation improvement (CDI) initiatives to enhance the quality of medical records.
Collaboration and Training:
Collaborate with co-workers, sharing expertise in complex coding scenarios.
Participate in coding workshops, meetings, and training sessions to further education and knowledge.
COMPETENCIES
Must adhere to productivity standards as set by MCNDH.
Attention to detail and accuracy in coding.
Strong communication skills to interact with healthcare providers and billing staff.
Problem-solving skills for resolving coding issues.
Ability to work independently and manage time effectively.
Regular attendance is required.
Performs other duties as assigned.
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.