Employment Opportunities

General Description

Responsibilities & Duties

1. Evaluates medical, dental, optometry, and behavioral health record documentations and charge-ticket coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflects and supports outpatient visits and to ensure that data complies with legal standards and guidelines.
2. Interprets providers documented information such as diseases or symptoms and diagnostic descriptions and procedures to accurately assign and sequence the correct ICD-10-CM, CPT, HCPC’s, Modifier’s and CDT codes.
3. Reviews Medicare, Medicaid, Managed Care and Commercial insurance company’s reimbursement claims for completeness and accuracy before submission to minimize claim denial.
4. Evaluates records and prepares reports on such topics as the number of denied claims or documentation or coding issues for review by the Revenue Integrity Officer and Compliance Officer.
5. Develops and updates procedures manuals to maintain standards for correct coding, to minimize the risk of fraud and abuse, and to optimize revenue recovery.
6. Provides technical guidance to physicians and other staff in identifying and resolving issues or errors such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, and/or codes that do not conform to approve coding principles/guidelines.
7. Read bulletins, newsletters, and periodicals and attends workshops to stay abreast of issues, trends, and changes in laws and regulations governing medical record coding and documentation.
8. Educates and advises staff on proper code selection, documentation, procedures, and requirements.
9. Identifies training needs, prepares training materials, and conducts training for physicians and support staff to improve skills in the collection and coding of quality health data.
10. Performs coding validation to ensure that the diagnoses/procedures submitted on the claim are supported by the clinical record documentation and appropriate billing by contact.
11. Contribute to team effort by accomplishing related results as needed
12. Promote effective working relations and work effectively as part of a team to facilitate the department’s ability to meet its goals and objectives
13. Demonstrate respect and regard for the dignity of all patients, families, visitors, and fellow employees to insure a professional, responsible and courteous environment
14. Perform other duties as assigned
15. Accurately assign codes to all claims following the standards of ethical coding, developed by AMA and in accordance with the ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes and coding conventions.
16. Participates in organization-wide quality improvement initiatives as requested.
17. Safeguards confidentiality of the medical charts/electronic health records and complies with all local, state, and federal laws pertaining to medical records.  Assures compliance with all HIPAA regulations concerning use, retrieval, storage, and sharing of medical records.
18. Other duties as assigned.

Qualifications

• High School Degree with 5 years’ experience in coding or Associates degree or equivalent with 2-4 years of experience in medical records and/or medical data entry. 
• Three years in a fast paced medical office setting, preferred.
• CPC-Certified Professional Coder
• COC-Certified Outpatient Coder preferred.
• RHIT – Registered Health Information Technician
• Documented training and experience in maintenance of medical records and ICD-10-CM/DRG coding.
• eClinical works E H R systems experience is preferred.
• Must have a valid Oklahoma Driver’s License.
• Must be able to pass a background check.

• A working knowledge of medical terminology and physiology and legal aspects of health information
• Knowledge of ICD-9-CM and CPT coding guidelines; medical terminology; anatomy and physiology; state and federal Medicare reimbursement guidelines; English grammar and usage.
• Ability to research and analyze data, draw conclusions, and resolve issues; read, interpret, and apply policies, procedures, laws, and regulations.
• Ability to read and interpret medical procedures and terminology.
• Ability to develop training materials, make group presentations, and to train staff
• Ability to exercise independent judgment;
• Excellent written and verbal communication skills to prepare reports and related documents and to maintain working relationships with physicians and other staff.
• Ability to maintain confidentiality.
• Knowledge of accreditation standards and compliance requirements.
• Must have knowledge of or experience in working with third party resources such as Medicare, Medicaid and Private Insurance, Contract Health or Coordination of Benefits, medical records, and patient registration. 
• Must be reliable, detailed oriented, capable of multi-tasking with excellent written and verbal communication skills as well as strong professional customer- service interpersonal skills.  
• Ability to communicate effectively orally and in writing; ability to relate well with co-workers and the general public.
• Ability to adjust to changing conditions.
• Must be computer literate required (Windows operating systems – Microsoft Word, Excel). 

• Must be able to sit, stand, stoop, bend or kneel for long periods of time.
• Sitting or standing or walking for long period of time; occasional bending, squatting, kneeling, stooping; good finger dexterity and feeling; frequent repetitive motions; talking hearing and visual acuity.
• Frequent lifting (up to 15 lbs)
• Occasional lifting (up to 30 lbs)