Medical Coder

St. Croix Chippewa Indians of Wisconsin Leadership will strive to uphold the mission, vision, and values of the organization. They will serve as role models for staff and act in a people centered, service excellence-focused and results oriented manner.

Position Summary: This position reports to the Business Office Manager and is responsible for reviewing analyzing, and coding diagnostic and procedural information that determines Medicare, Medicaid and private insurance payments.

Essential Functions: Medical codes are used to identify diagnoses and procedures provided during an office visit. The medical coder primarily uses these codes for billing and reimbursement of insurance. Therefore, a medical coder is expected to possess a thorough knowledge of the data contained in health records in order to find the necessary information for coding purposes. The Medical coder is trained in anatomy and physiology, disease processes as well as the related codes for diagnoses, procedures and treatments.

Job Duties:

• Interprets the diagnosis, treatment and procedures in a patient’s record and assigns the proper procedural and diagnostic codes for billing purposes and insurance reimbursement;
• Applies ICD-10-CM and CPT (Current Procedural Terminology) codes for services and procedures that take place within the FQHC setting and maintains up-to-date knowledge of changes in industry standards and regulations;
• Adds appropriate HCPCS (Healthcare Procedure Coding System) alphanumeric codes and modifiers as needed;
• Assigns appropriate Evaluation and Management codes for each visit by reading the provider’s dictation to determine the appropriate level of service provided;
• Educates the providers in proper documentation and alerts them of upcoming changes and education that may be warranted. This involves working closely with the providers to maintain adequate documentation and improve quality of reimbursement;
• Works with Medical, Dental, Optometry, Behavioral Health, Community Health, and Public Health claims. Array of services Coder is responsible for is subject to change based on specialization and/or expansion of services;
• Maintains awareness of quarterly CMS (Centers for Medicare & Medicaid Services) changes and coding guidelines;
• Assists with goals of Business Office, including but not limited to, expansion of reimbursable services
• Responsible for maintaining Certified Professional Coder credential;
• Any other duties assigned by supervisor

Note:The essential functions are intended to describe the general contents of and requirements of this position and are not intended to an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent’s immediate manager.

Type of Supervisory Responsibilities: N/A

Supervisory Responsibilities: N/A

Directly Reporting to: Business Office Manager

Matrix of INDIRECT Reporting: St. Croix Tribal Council

Scope and Complexity: Interacts with all levels of management and employees; often trusted with maintaining confidentiality and relaying highly sensitive messages, and appropriate application of business operations and practices.

Physical Demands/Environment Factors:

• Requires extensive sitting with periodic standing and walking.
• May be required to lift up to 50 pounds.
• Requires significant use of personal computer, phone and general office equipment.
• Needs adequate visual acuity, ability to grasp and handle objects.
• Need ability to communicate effectively through reading, writing, and speaking in person or on the telephone.
• May require off-site travel.

Minimum Qualifications

• Certification as a CPC (Certified Professional Coder) granted by a medically recognized organization
• Knowledge and experience with CPT, HCPCS and ICD-10 coding
• Knowledge and experience with Evaluation and Management coding
• Knowledge of HCPCS codes and modifiers
• Completed Medical Terminology course
• Completed Anatomy and Physiology course
• Knowledge or training with keyboarding and word processing
• Ability to learn claims filing procedures
• Maintain patient confidentiality in accordance with the Federal Privacy Act and HIPAA
• Ability to work independently
• Experience with or ability to learn the agency EHR system and perform coding related duties within the program
• Maintain good communication skills in working with providers and medical staff as needed to ensure correct information before billing process begins
• Ability to learn and navigate the Electronic Health Records and ancillary applications, performing coding related duties within the program

Preferred Qualifications:

• One year of Medical Coding experience in a Health Clinic setting;
• Prior experience working with the current Electronic Health Record system, NextGen EHR;
• Experience with a Native American Tribal organization, Federally Qualified Health Center, or Community Health Center.

Native American Preference Given in Accordance with P.L. 93-638 and Amendments

Job Type: Part-time

Pay: From $21.14 per hour

Expected hours: No more than 29 per week

Benefits:

• Employee discount

Schedule:

• Day shift
• Monday to Friday

Work Location: In person

Salary : $21