BILLING TECHNICIAN

POSITION DESCRIPTION

The Billing Technician/Certified Coder shall accurately code the patient’s record to be sent to billing for processing.

ESSENTIAL DUTIES & RESPONSIBILITIES

1. The incumbent performs highly technical and specialized functions for an Outpatient medical record.
2. Reviews, analyzes and codes diagnostic and procedural information that determines Medicare, Medicaid and Private Insurance company payments.
3. Assigns and sequences ICD-9-CM, CPT and HCPCS codes to diagnoses and procedures from documented information. Assures the final diagnose and operative procedures, as stated by the physician, are valid and complete. Abstracts all necessary information from the medical record to identify secondary complications and co-morbid conditions.
4. Determines the final diagnose and procedures stated by the physician are valid and complete. The incumbent correctly sequences diagnoses, in consultation with the attending physicians as necessary.
5. Codes diagnoses and procedures from the medical record. Assures the final diagnose and operative procedures as stated by the physician are valid and complete. Abstract all necessary information from the record to reflect secondary complications and co-morbid conditions. Codes complex and difficult records correctly. Makes complete and accurate selection of the primary diagnosis and procedure/operation. When multiple diagnoses and procedures are listed, assures the surgical procedure is related to the proper diagnosis.
6. Provides education and coding updates to medical staff, business office staff, and other health care providers on ever-changing coding rules and regulations and guidelines.
7. Performs data entry to enter medical data into RPMS.
8. Codes medical records applying a thorough knowledge of various medical and clinical processes such as disease, illness or injury and conditions and their interrelationships to code correctly. Incumbent abstracts all necessary information and assigns codes, which most accurately describes each documented diagnosis, surgical procedure and special therapy or procedures according to established guidelines and practices. When multiple diagnoses and procedures are listed, they must relate each surgical procedure to the proper diagnosis. Selects and assigns a primary code along with other codes. Maintains other related records and files as required.
9. All coding will be completed within in a 24 hour period of time to comply with CMS rules and regulations. Will work with Providers on a diligent bases insuring the providers are complying with this mandate.
10. Responsible for active participation within the Revenue Enhancement cycle and all meetings pertaining to revenue enhancement.
11. Backup for IT and HIMS at all times.
12. Performs other duties as assigned by upper echelon.
13. Other job related duties as assigned by the supervisor.

KNOWLEDGE, SKILLS & ABILITIES

1. Must have a High School Diploma or GED certificate.
2. Must have Associates Degree Health Information Technology (HIT) or Health Information Management (HIM)
3. Two (2) years’ experience in coding is preferred
4. Experience in word processing, operating a computer terminal and other office equipment is helpful, but will train.

QUALIFICATION REQUIREMENTS

(To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions)

1. Must possess certification by the American Health Information Management Association (AHIMA) as a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Specialist-Physician Based (CCS-P), or Certified Coding Associate (CCA) and/or the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC).
2. Candidate must be able to maintain medical information in a confidential manner.
3. Must be organized and be able to records filings and on confidentiality and the Privacy Act communicate effectively. Training will be provided on telephone techniques, customer relations, and medical.

EMPLOYMENT INFORMATION

Fallon Paiute-Shoshone Tribe and Native American/Indian Preference:  Employment preferences to members of the Fallon Paiute-Shoshone and to members of federally-recognized Indian Tribes shall apply to this position pursuant to the Tribe’s Personnel Policies.  Persons of Tribe and/or Indian ancestry and wish to claim these employment preferences should submit a copy of the Tribal Enrollment Card/Certification indicating the name of the Tribe they are enrolled with.

U.S. Veteran’s Preference:  Preference to opportunities to veterans honorably discharged from the United States Armed Forces shall apply to this position pursuant to the Tribe’s Personnel Policies.

Equal Opportunity Employer:  The Fallon Paiute-Shoshone Tribe does not discriminate on the basis of race, color, national original, sex, religious preference, age, handicap, marital status, political preference, genetics or membership or non-membership in any employee organization, except as allowed by Federal and/or Tribal Law.

Drug Free Workplace:  The Fallon Paiute-Shoshone Tribe is a drug-free workplace.  All employees are subject to a pre-employment and random drug screens.

Driving Record:  Employees who drive tribal vehicles must have a valid Nevada Driver’s License, be insurable under the Tribe’s vehicle insurance program, and must also provide a DMV printout annually.

Background Checks:  All employees must be able to pass a background check per the Tribe’s Background Check Policy.

Position Description Limitations:  This position description does not constitute an employment agreement between the Tribe and the employee, and is subject to change by the Council as the needs of the Tribe and the requirements of the job change.  This position description is not intended to present a descriptive list of the range of duties performed by any employee in this position and is not intended to reflect all duties performed within the position.