Description
SALARY: $20.73/Hr. (NEGOTIABLE)
Non-Exempt
POSITION SUMMARY This position will coordinate the processing of fees for professional services provided to patients, for the purpose of reimbursement. Analyze patient medical records to assure that documentation by providers conforms to legal and procedural requirements. Continuation of this position is contingent upon funding allocations.
DUTIES AND RESPONSIBILITIES:
1. Assign specified codes to medical diagnoses and/or clinical procedures.
2. Interact with physicians and other providers regarding billing and documentation policies and procedures.
3. Analyze and interpret patient medical records to identify and determine amount and nature of billable services; assign and sequence appropriate diagnostic/procedure billing codes in compliance with requirements of third-party payer requirements.
4. Interact with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation.
5. Monitor billing performances to ensure optimal reimbursement while adhering to regulations prohibiting unbundling and other questionable practices; prepare periodic reports for clinical staff identifying unbilled charges due to inadequate documentation.
6. Interact with department heads and other administrative staff regarding implementation of new codes and revision of charge documents.
7. Research inquiries from providers and patients about fees, reimbursements, and denials.
8. Monitor external data sources to ensure receipt and analysis of all charges.
9. Ensure strict confidentiality of financial and medical records.
10. Follow established departmental policies, procedures, and objectives, continuous quality improvement objectives, and safety and environmental standards.
11. Adhere to all Tribal Personnel Policies and Procedures, Tribal Standard Operating Procedures, and Area and Program Strategic Plans and Policies.
12. The above duties and responsibilities are not an all-inclusive list but rather a general representation of the duties and responsibilities associated with this position. The duties and responsibilities will be subject to change based on organizational needs and/or deemed necessary by the supervisor.
PHYSICAL REQUIREMENTS/WORK ENVIRONMENT:
1. Frequently stand reach with hands and arms; and talk and hear. Occasionally sit, stoop, kneel, crouch; lift and/or move up to twenty-five (25) pounds.
2. Work is generally performed in an office setting.
3. Evening and/or weekend work may be required. Extended hours and irregular shifts may be required.
4. A Tuberculosis (TB) Screening and/or a 2 step TB Skin Test is required within thirty (30) days of employment.
STANDARD QUALIFICATIONS:
1. Knowledge of applicable federal, state, county and local laws, regulations, and requirements.
2. Knowledge of medical terminology.
3. Knowledge of auditing concepts and principles.
4. Knowledge of legal and policy constraints pertaining to patient billing.
5. Knowledge of current and developing issues and trends in medical coding procedures requirements.
6. Knowledge of ICD-10, HCPC and/or CPT medical billing codes.
7. Skill in operating business computers and office machines, including word-processing, spreadsheets, database software programs, POS system and e-mail.
8. Skill in preparing and maintaining patient records.
9. Ability to gather data, compile information, and prepare reports.
10. Ability to analyze and solve problems.
11. Ability to analyze complex medical records and identify billable services.
12. Ability to maintain quality and safety standards.
13. Ability to use independent judgment and to manage and impart confidential information.
14. Ability to communicate technical information to non-technical personnel.
15. Ability to communicate effectively in the English language, both verbally and in writing.
16. Ability to establish and maintain professional relationships with the public and co-workers.
17. Ability to handle multiple tasks and meet deadlines.
18. Complete Oneida Certification on Reporting Child Abuse and Neglect training within ninety (90) days of employment.
19. Maintain strict departmental security, confidentiality, and quality to meet professional standards of the department.
20. Must adhere to strict confidentiality in all matters.
21. Must complete Health Insurance Portability and Accountability Act (HIPAA) training within 30 days of employment and annually thereafter.
22. Must be willing and able to obtain additional education and training.
23. Must pass a pre-employment drug screening. Must adhere to the Oneida Nation's Drug and Alcohol-Free Workplace Policy during employment.
24. Employees are required to have proof of immunity or dates of 2 doses of MMR and Varicella prior to starting in any position within the Oneida Comprehensive Health Division. Any refusal of vaccination(s) or failure to provide proof of immunity may disqualify the applicant.
25. Must comply with Caregiver Law and Grant conditions criminal history checks as a condition of employment to include fingerprinting.
26. Must pass a background security check with the Oneida Nation to meet the Employment Eligibility Requirements, Tribal/State Compact and/or Oneida Nation Gaming Ordinance as they pertain to the position. A temporary license or Gaming License issued by the Oneida Gaming Commission is required as a condition of employment and continuing employment within the Oneida Nation Gaming Division.
27. A valid, non-probationary driver's license or occupational driver's license, reliable transportation, and insurance are required. Must obtain a Wisconsin non-probationary driver's license or occupational driver's license within thirty (30) days of employment if applicant has an out-of-state driver's license. Must be authorized as eligible to operate a Personal and Tribal vehicle under the Oneida Nation's Vehicle Driver Certification and Fleet Management Policy prior to actual start date. Must maintain driver's eligibility as a condition of employment.
MINIMUM QUALIFICATIONS:
Applicants please clearly state how you meet these qualifications on the application/resume.
1. High School Diploma, HSED Diploma or GED Certification; applicants age fifty (50) and older are exempt from this requirement.
2. Six (6) months experience as a medical coder.
3. Professional Medical Coding Certificate.
ITEMS TO BE SUBMITTED:
1. Must provide a copy of diploma, license, degree or certification upon employment.
2. Must have received or be willing to receive the COVID-19 vaccination by date of hire to be considered. Proof of vaccination required.
3. Background information disclosure (BID) form.
Department: Administration
This is a full time position
Job Code: 00064
Closing Date: Until Filled
Responsible to: Medical Records Supervisor
Transfer Date: 08/25/2023
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