Closing Date: April 28, 2023 at 4PM MST

Salary Range: $19.06 – $22.88/Hr.

**APPLICANT MUST HAVE A VALID, UNRESTRICTED INSURABLE DRIVER’S LICENSE**

**RESUMES AND REFERENCES ARE REQUIRED**

ESSENTIAL DUTIES, FUNCTIONS AND RESPONSIBILITIES

• Retrieves information from the RPMS in identifying the patients; and reviews medical records to ensure FDIHB providers assign the correct diagnosis and procedural codes.
• Assigns and categorized codes using the International Classification of Diseases, tenth revision, Clinical Modification (ICD-10-CM), International Classification of Diseases, Tenth Revision, Procedural Coding System (ICD-10-PCS), Current ProcedureTerminology (CPT), Health Common Procedure Coding System (HCPCS) Code, coding guidelines and other policies set by FDIHB, Centers for Medicare and Medicaid Services(CMS) or other regulatory organizations as related. Uses the 3M Grouper System to assist in classifying diagnoses and verifying the accuracy of coding assignments.
• Abstracts all necessary information by auditing and analyzing patient care component forms (PCC), Electronic Health record for the appropriate Evaluation and Management(E&M) levels, CPT and the HCPCS codes that accurately describe each medical/surgical procedures/supplies on each patient visit.
• Performs quantitative analysis to ensure the presence of all component parts of the records as patient name, health record number, dates of service and time, signatures where required on paper forms and/or E.H.R. and the presence of all reports, which are indicated by the nature of the visit. Evaluates the records for internal consistency, completeness and accuracy for sufficient data to justify the diagnoses and procedures assigned. Identifies inconsistencies or discrepancies among medical documentation and discusses with appropriate staff members and physicians without infringing on decisions concerning a medical provider or physician’s clinical judgment.
• Performs quality data entry of protected patient health information into the RPMS and3M Grouper systems, which requires extensive interaction with the RPMS-PCC system using mnemonics for entering and editing data. Performs audits and medical reviews by running error listings and/or other data reports to ensure documentation and accountability of all data. Reviews and completes zero reports where PCC plus System is in place, RPMS Audit list reporting to capture all data missed and/or errors hanging in the system in a timely manner.
• Ensures the validity, completion and disposition of all clinical records briefs reflecting encoded and other patient-related information. Maintains confidentiality of health information in accordance with the Privacy Act of 1974 and Health InformationPortability Accountability Act (HIPAA) of 1996, Alcohol and Drug Abuse PatientRecords, Freedom of Information Act and other mandatory federal regulations.
• Works with clinical staff in coordinating the workflow such as PCC+ system and ensuring up-to-date codes are maintained in the RPMS, and by surveying potential risk areas and identifying inconsistencies or discrepancies within the medical records and discusses with the appropriate medical, nursing, and/or healthcare providers for corrective action without infringing on decisions concerning a physician’s clinical judgment.
• Monitors specific areas as indicated for areas of improvement by recognizing potential risks subjected to compliance issues such as coding and data entry. Incumbentdocuments findings prepare reports to present to immediate supervisor. Performs quality assurance/performance functions for the department to ensure qualities of services are provided. Prepares reports, presents to staff and Quality Assurance Committee as needed.
• Completes all RCM Queries within 24 hours upon receiving.
• Uses coding guidelines and resources that include the Encoder (3M), ICD-10 CM, ICD10-PCS, CPT, HCPCS, and other coding classification systems, RPMS user’s guide, PDR, the Privacy Act, HIPPA regulations, medical dictionaries, FDIHB policies and procedures, CMS, the Revenue Cycle Management Compliance Plan, Health Recordsguidelines, written and oral policies and procedures.
• Conducts quality control and improvement reviews by; tracking and identifying inadequate documentation for coding; communicating program software and hardware problems; and by maintaining a deficiency and productivity logs. Works with clinical providers on clinical documentation improvement and coordinates with providers to correct deficiencies identified for processing of coding visits.
• Maintains the integrity of patient information; including but not limited to, protecting from any unauthorized disclosures, breaches, or altering/destroying of patient information.
• Complies with FDIHB policies governing user access of accounts to complete daily work duties; and ensures confidentiality in accordance with the Privacy Act of 1974, Alcohol and Drug Abuse Patient Records, Freedom of Information Act, HIPAA and other pertinent federal regulations. Reports any security breaches or potential breaches to the immediate supervisor.
• Keeps abreast of the latest and new concepts and techniques in coding, regulations and related resources pertaining to diagnostic and procedure codes. Continues pursuit and development of job-related individual interests and specialty areas for both personal growth and program and services enhancement.
• Performs other duties as assigned.

MANDATORY MINIMUM QUALIFICATIONS:

Experience: Two (2) years of outpatient coding experience in a healthcare setting. Under the Certified Outpatient Coding Apprenticeship, FDIHB RCM- Outpatient Coders will provide technical guidance for the duration of one (1) year to fulfill the completion of the apprenticeship.

Education: High School Diploma or Equivalency (HSE).

• Coding Certification by the American Health Information Management Association(AHIMA) or, the American Academy of Professional Coders (AAPC). Certified CodingAssociate (CCA), Certified Coding Specialist (CCS), Certified Coding Specialist-Physician-based (CCS-P) or Coding Certification by, the American Academy of Professional Coders (AAPC), Certified Professional Coder (CPC), Certified ProfessionalCoder – Apprentice (CPC-A) Certified Outpatient Coding (COC), Certified InpatientCoder (CIC)

Please email degree or transcripts to trent.begay@fdihb.org

NAVAJO/INDIAN PREFERENCE:

FDIHB and its facilities are located within the Navajo Nation and, in accordance with Navajo Nation law, has implemented a Navajo/Indian Preference in Employment Policy. Pursuant to this Policy, applicants who meet the minimum qualifications for this position and who are enrolled members of the Navajo Nation will be given primary preference in hiring and employment for this position and members of other federally recognized Indian tribes will be given secondary preference. Other candidates will be considered only after all candidates entitled to primary or secondary preference have been fully considered.

Experience

• 2 year(s): Two (2) years of outpatient coding experience in a healthcare setting. Under the Certified Outpatient Coding Apprenticeship, FDIHB RCM- Outpatient Coders will provide technical guidance for the duration of one (1) year to fulfill the completion of the apprenticeship.

Education

• High School Dip/GED or better

Licenses & Certifications

• Certified Coding Assoc.
• Certified Coding Spec.
• Certified Inpt. Coder
• Certified Outpt. Coding
• Certified Prof Coder
• Cert Prof Cod Apprentice