Outpatient Coder

Overview

In our hourly positions, we look for dedicated individuals who value respect, take pride in accountability, and embrace a culture of collaboration and excellence. As an integral part of our team, you will contribute to a positive and supportive environment where every effort is appreciated, and every role is essential. Your commitment to upholding our values and maintaining a strong work ethic will help us achieve shared success.

Primary Objectives

The Outpatient Coder is a key line-level position responsible for interpretation, analysis, and assignment of diagnostic and procedural codes, promoting continuity of medical care, and ensures compliance with third party reimbursement policies, regulation, and accreditation guidelines. This job description is not an all-inclusive list of the duties and responsibilities of this position. PCI Employees are expected to perform all duties and responsibilities necessary to meet the goals and objectives of applicable programs and departmental objectives, as assigned. This role plays a strong commitment to understanding and embracing the Poarch Creek Indians Values of Perseverance, Opportunity, Accountability, Respect, Culture, and Honesty.

Essential Functions

• Performs qualitative analysis of the medical record for documentation consistency and adequacy. Ensures that the final diagnosis accurately reflects the care and treatment rendered.
• Performs quantitative analysis of the medical record to assure all component parts, i.e., patient name, signatures, record number, and all reports indicated by the treatment are present.
• Makes final determination that medico-legal requirements of the record is complete, accurate, and reflects sufficient data to justify the diagnosis and warrant treatment and end results.
• Assigns and sequences ICD-10 CM, CPT-4, and HCPCS codes according to regulating guidelines. The coding applies to both revenue (CPT, ICD-10, HCPCS) and quality measures.
• Thoroughly review all chart documentation prior to assigning codes.
• Maintains strict confidentiality in accordance with the HIPAA and Privacy Act.
• Answers coding questions from other departments and outside calls.
• Communicates with providers when there is ambiguous statements or lack of documentation, which ensures compliance with Federal regulations.
• Works closely with HIM Department before medical records are released to third party payers.
• Ensures that the coding queue and other coding reports are "cleaned up" at the end of every month to correct errors and code any missed visits.
• Attends all appropriate coding and compliance training to update the Health Department on new developments and changes to regulations. This includes maintaining certification by attaining the appropriate amount of CEU's annually.
• Complies with all Federal and State laws / regulations.
• Performs other duties as assigned by the appropriate person.

Job Requirements

Core Competencies Required

Compensation and Benefits

Every applicant must complete an application provided by Human Resources. A resume will not be accepted in the place of an application.

Please note ALL individuals selected for employment are required to complete a background investigation. Individuals being placed in positions designed as child-sensitive or data-sensitive must successfully complete a background check prior to employment.

INDIAN PREFERENCE, SPOUSAL PREFERENCE, OR FIRST GENERATION :

In the event more than one applicant meets the requirements, as stated in a job description, preference shall be given in the following order : (1) Tribal Member (2) First Generation Descendant of a Tribal Member (3) Spouse of Tribal Member (4) Indian (5) Non-Indian

In the event that a position of employment is funded in whole or in part my any federal grant and / or contract or other public funding, preference shall be given in the following order : (1) Indian (2) Non-Indian

In order to receive preference, the appropriate documentation must be submitted.

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