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Certified Professional Coder

Job Description

POSITION SUMMARY: Under the general supervision of the Lead CPC , the Certified Professional Coder reviews the patient health record documentation and assures assignment of correct diagnosis and procedure codes which will be used for billing and reimbursement purposes.

ESSENTIAL JOB FUNCTIONS: Essential functions, as defined under the Americans with Disabilities Act, may include any of the following tasks, knowledge, skills, and other characteristics. The list that follows is not intended as a comprehensive list, but rather to provide a representative summary of the major duties and responsibilities. Incumbent(s) may not be required to perform all duties listed, and may be required to perform additional supportive tasks.

PRIMARY TASKS:

1. Abstracts all necessary information from clinical notes to ensure proper coding and reimbursement.

2. Performs a comprehensive review for the record to ensure the presence of all component parts such as: Patient and records identifications, signatures and dates where required and any other necessary data.

3. Reviews the records for compliance with established third party reimbursement agencies.

4. Have a working knowledge of Insurance guidelines including Medicare and Medi-cal.

5. Work with physicians and medical staff to ensure patient visits are documented and completed within NVIH current Policy.

6. Collect and report data as necessary and required by related agencies.

7. Maintain security and accuracy of patient data base.

8. Coordinate with other key personnel in facilitating any coding issues or concerns

9. Meets all monthly coding deadlines in order to billing to be completed on a timely basis.

10. Participates in Coding meetings as-needed. Participates in the implementation of Corrective Action Plans for addressing any coding audit findings.

11. Data entry duties.

SUPPORTIVE TASKS:

1. Process prior authorization requests.

2. Manage referral tracking follow-up and reports.

2


3. Perform scanning duties.

4. Other duties as assigned.

Job Requirements

QUALIFICATION/EXPERIENCE:

1. High School Diploma or equivalent, GED.

2. Coding Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA).

3. Able to maintain current coding certification.

4. Able to communicate with provider staff in order to clarify diagnoses/procedures and sequencing of diagnoses.

5. Has general knowledge of common medical terminology and gross anatomy.

6. Has extensive knowledge of each coding book (CPT, ICD (current version), HCPCS).

7. Ability to maintain current knowledge of medical coding rules and regulations pertaining especially to medical coding compliance and reimbursement.

8. Ability to communicate to staff regarding updates in coding rules and guidelines.

9. Ability to communicate to provider staff guidelines for accurate and detailed documentation of each patient encounter.

All NVIH employees are expected to:

- Provide the highest possible level of service to clients;

- Promote teamwork and cooperative effort among employees;

- Maintain safe practices; and

- Abide by the NVIH’s policies and procedures as they may from time to time be updated.

INDIAN PREFERENCE:. Preference in filling vacancies will be given to qualified Indian applicants in accordance with Indian Preference Act (Title 25, U.S. Code Section 472 & 473). In other than the above, Northern Valley Indian Health, Inc. is an Equal Opportunity Employer.

Job Snapshot

Location US-CA-Chico
Employment Type Full-Time
Pay Type Hour
Pay Rate $15.70 - $23.73 /Hour
Store Type Health Care
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Company Overview

Northern Valley Indian Health

True to the mission of its founders, Northern Valley Indian Health’s central purpose is to provide health services to eligible American Indians in the service areas of Colusa and Glenn Counties and portions of Butte and Tehama Counties. Medical and Dental services are provided to the general community as well. NVIH has Medical clinics in Willows, Woodland, in Chico at the Children’s Health Center, and at our main Chico site. We also have Dental clinics in Willows, Chico, Woodland, and Red Bluff, as well as a Mobile Dental Clinic. Learn More

Contact Information

US-CA-Chico
Nina Turner
(530) 896-9400 x2225
530-924-2042
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Snapshot
Northern Valley Indian Health
Company:
US-CA-Chico
Location:
Full-Time
Employment Type:
Hour
Pay Type:
$15.70 - $23.73 /Hour
Pay Rate:
Health Care
Store Type:

Job Description

POSITION SUMMARY: Under the general supervision of the Lead CPC , the Certified Professional Coder reviews the patient health record documentation and assures assignment of correct diagnosis and procedure codes which will be used for billing and reimbursement purposes.

ESSENTIAL JOB FUNCTIONS: Essential functions, as defined under the Americans with Disabilities Act, may include any of the following tasks, knowledge, skills, and other characteristics. The list that follows is not intended as a comprehensive list, but rather to provide a representative summary of the major duties and responsibilities. Incumbent(s) may not be required to perform all duties listed, and may be required to perform additional supportive tasks.

PRIMARY TASKS:

1. Abstracts all necessary information from clinical notes to ensure proper coding and reimbursement.

2. Performs a comprehensive review for the record to ensure the presence of all component parts such as: Patient and records identifications, signatures and dates where required and any other necessary data.

3. Reviews the records for compliance with established third party reimbursement agencies.

4. Have a working knowledge of Insurance guidelines including Medicare and Medi-cal.

5. Work with physicians and medical staff to ensure patient visits are documented and completed within NVIH current Policy.

6. Collect and report data as necessary and required by related agencies.

7. Maintain security and accuracy of patient data base.

8. Coordinate with other key personnel in facilitating any coding issues or concerns

9. Meets all monthly coding deadlines in order to billing to be completed on a timely basis.

10. Participates in Coding meetings as-needed. Participates in the implementation of Corrective Action Plans for addressing any coding audit findings.

11. Data entry duties.

SUPPORTIVE TASKS:

1. Process prior authorization requests.

2. Manage referral tracking follow-up and reports.

2


3. Perform scanning duties.

4. Other duties as assigned.

Job Requirements

QUALIFICATION/EXPERIENCE:

1. High School Diploma or equivalent, GED.

2. Coding Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA).

3. Able to maintain current coding certification.

4. Able to communicate with provider staff in order to clarify diagnoses/procedures and sequencing of diagnoses.

5. Has general knowledge of common medical terminology and gross anatomy.

6. Has extensive knowledge of each coding book (CPT, ICD (current version), HCPCS).

7. Ability to maintain current knowledge of medical coding rules and regulations pertaining especially to medical coding compliance and reimbursement.

8. Ability to communicate to staff regarding updates in coding rules and guidelines.

9. Ability to communicate to provider staff guidelines for accurate and detailed documentation of each patient encounter.

All NVIH employees are expected to:

- Provide the highest possible level of service to clients;

- Promote teamwork and cooperative effort among employees;

- Maintain safe practices; and

- Abide by the NVIH’s policies and procedures as they may from time to time be updated.

INDIAN PREFERENCE:. Preference in filling vacancies will be given to qualified Indian applicants in accordance with Indian Preference Act (Title 25, U.S. Code Section 472 & 473). In other than the above, Northern Valley Indian Health, Inc. is an Equal Opportunity Employer.

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