What are the responsibilities and job description for the Certified Coder - Remote TEMP - Closes 10/29/2025 position at United Indian Health Services, Inc?
SUMMARY: The primary function of this position is to review ICD, CPT and HCPCS coding for data and reimbursement. The coding function is a primary source for data and information used in health care today, and promotes quality client care, captures accurate reporting numbers and optimizes reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
Level I
- Performs comprehensive review of the health record, evaluates the record for documentation, consistency, accuracy and correlation of recorded data. Ensures the final diagnosis as stated by the provider is valid, complete and accurately reflects the care and treatment rendered.
- Consults with provider when conflicting or ambiguous documentation is present. Requests correction of the record before assigning a code that is not supported by documentation.
- Assigns and sequences International Classification of Diseases (ICD), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), Current Dental Terminology (CDT), Diagnostic and Statistical Manual of Mental Disorders (DSM) codes to diagnosis and procedures from documented information.
- Adheres to all official coding guidelines, conventions, standards of ethical coding and rules established by the American Health Information Management Association (AHIMA), American Academy of Professional Coders (AAPC), American Medical Association (AMA), and Centers for Medicare & Medicaid Service (CMS).
- Assists with performing routine audits in accordance with the facility Compliance Plan and Quality Improvement, which may include findings from provider documentation trends, coding peer reviews, and reimbursement denials.
- Reviews the records for compliance with established third party reimbursement agencies and special screening criteria.
- Provides medical staff and other healthcare providers education on coding and classification systems, including updates or changes in coding conventions or rules, documentation guidelines, and rules and regulations governing reimbursement.
- Analyzes provider documentation to assure the appropriate Evaluation & Management (E&M) levels are assigned using the correct CPT code.
- Participates in committee I staff meetings as delegated by the supervisor.
- Performs all duties according to established safety procedures and UIHS policy.
- Performs other duties assigned by the Operating Revenue Manager.
Level II
NextGen Certified Professional
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Serve as the primary resource for:
- Training and supporting UIHS Coders.
- Medical providers regarding coding, workflows, addendums, and templates.
- Troubleshooting technical systems including NextGen Practice Management, ClaimRemedi, and reporting and claims issues.
- Assist in preparing financial reports as needed for fiscal audits and reconciliations.
SUPERVISORY RESPONSIBILITIES: This position is a not a supervisory position. The incumbent reports to the Operating Revenue Manager.
QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION /EXPERIENCE: Educational degrees must be from a US Department of Education accredited school
Level I
- Must have High School Diploma or equivalent.
- Two years of coding experience using ICD-10-CM or equivalency. The incumbent is expected to enroll in continuing education courses to maintain certification; many of which will be provided by UIHS. Six to twelve months would be required to become proficient in most phases of the job.
Level II
- All education listed as above and five (5) years of coding experience, or
- Associates Degree or equivalent and two (2) years of direct, unsupervised coding experience