Certified Medical Coder

This is a fully remote position, open to applicants in South Dakota.

📋 Description

• Transform medical diagnoses, supplies, and procedures into standardized codes for insurance reimbursement.

• Ensure compliance with coding regulations set by Medicare, Medicaid, and private insurance providers.

• Analyze and abstract medical record data concerning secondary complications and comorbidities.

• Code diagnoses and procedures while confirming the validity and completeness of provider documentation.

• Accurately code intricate records and select and order principal diagnoses and procedures.

• Confirm that medication, laboratory, and radiology orders align with service levels and medical necessity.

• Ensure that medical records are properly identified, including health record numbers, signatures, dates, and comprehensive clinical notes.

• Assess service levels and make modifications when warranted based on documentation.

• Finalize medical records by reviewing data and alerting providers to any deficiencies.

• Monitor outstanding records and address discrepancies by gathering and analyzing information.

• Independently communicate with providers and billing personnel regarding coding and documentation concerns.

• Engage in performance improvement teams and assigned committees.

• Execute related duties accurately, promptly, and in accordance with established standards.

• Utilize required systems, tools, and technologies.

• Effectively communicate with both internal and external stakeholders.

⛳️ Requirements

• Completion of a formal training program or an associate’s degree with 1 year of relevant experience; alternatively, a high school diploma/GED with 3 years of relevant experience.

• Certification in Medical Coding.

• Understanding of HIPAA and HITECH regulations.

• Familiarity with medical records requirements and their functions.

• Proficiency in ICD-10, CPT 4, and HCPCS coding guidelines.

• Capability to apply standardized rules, procedures, or operations to perform clerical tasks and address recurring issues.

• Compliance with mandatory criminal background checks and pre-employment drug screenings.

• Adherence to employee health screening and immunization protocols, including MMR, Varicella, Hepatitis B, Influenza, T-dap, and COVID-19 vaccinations.

• Ability to perform essential job functions with or without reasonable accommodation.

• Competence in reading, writing, speaking, and hearing.

• Capacity to sit for extended periods and operate standard office equipment.

• Ability to occasionally lift and carry office materials or supplies weighing up to 25 pounds.

• Requirement to maintain consistent and dependable attendance.

• Adherence to organizational policies, procedures, and relevant laws and regulations.

🏝️ Benefits

• Tribal preference for qualified Indian/Tribal candidates when qualifications are equivalent.

• Employment contingent upon successful completion of criminal background checks and pre-employment drug screenings.

• Employee health screenings and necessary immunizations are covered by employment health procedures.

• Reasonable accommodations available for the essential functions of the job.