Perform all coding, a Clerical function, relating to Medical and accounts receivable. Coding for diagnoses, procedures and services performed by providers of the clinic will be audited for accuracy for billing all 3rd Party Payer’s, Medi-Cal including Medi-cal, Share of Cost, Medi-Care, Private Insurance meeting all payer, state and federal regulations.
***This position closes on Monday, May 06th 2019 ***
REQUIREMENTS/MINIMUM QUALIFICATIONS:
- Must have current experience in Medical.
- Certified Professional Coder.
- Must pass pre-employment drug screening.
- Indian preference.
ESSENTIAL JOB DUTIES:
- Collect ‘Kept Appointments with No Charges’ Report on a daily basis from the Medical department.
- Ensuring coding and Alternate Resource information is complete and current.
- Assists Clinic Operations Manager in monitoring fee schedules and recommends revisions when necessary.
- Audit Electronic Health Record (EHR) for appropriate supporting documentation and medical necessity of documentation compared to charges.
- Determining accurate codes for diagnoses, procedures and services performed by Physicians and recognized, licensed nonphysical providers in physician-based setting.(These services may include evaluation and management services as well as reviewing operative notes)
- Keeping current with medical compliance and reimbursement policies, such as medical necessity issues and correct coding issues.
- Providing physicians and staff with up-to-date coding information from reliable, accurate sources, such as specific payors, the AMA, AHA’s Coding Clinic, and CMS.
- Updating the clinic’s fee schedule based on Relative Value Unit (RVU) updates that come out annually and based on additions and deletions to codes for procedures, services and supplies.
- Audit for compliance per requests of the Quality Committee.
- Prepare and submit electronic charges to insurance.
- Complete tasks generated by RCM as follow-up.
KNOWLEDGE SKILLS AND ABILITIES
- Knowledge of Indian Health Service and HCFA programs preferred.
- Knowledge of Medical billing systems and regulatory requirements.
- Knowledge of HIPAA Compliance.
- Must have knowledge of Medi-Cal, Medicare and Private Insurance regulations, billing and coding procedures and electronic claims submissions.
- Ability to work with others and follow written and oral directions accurately.
- Ability to work in a team environment, both within the department as well as other departments.
- Computer experience and ability to operate office machines.
- Ability to be tactful and mature with the ability to work with a variety of personalities demonstrating objectivity, respect, courtesy and patience.
- Ability to handle multiple tasks and priorities.
- Good to excellent communication skills/interpersonal skills and telephone etiquette.
A completed Redding Rancheria job application must be submitted in order to be considered for employment. You can fill out an application online at www.reddingrancheria-nsn.gov, please fax (530-242-4563), email (employment@redding-rancheria.com) or bring in to Redding Rancheria at 2000 Redding Rancheria Road, Redding CA 96001.
All certifications, credentials/ licenses, education verification /degrees and/or transcripts, and Indian verification are required to process your application.
Indian preference applies, but we welcome all applicants who wish to apply for this position. To receive Indian preference, certification of Native American heritage needs to be attached to the job application.
Any offer of employment is conditioned upon the successful completion of a pre-employment drug screen and criminal background screening clearance. All employees are required to submit to a Tuberculosis test (TB) test after they are hired in addition to being tested annually.
Additional Information:
Redding Rancheria is a federally recognized Tribe with Pit River, Wintu and Yana people where pride in Tribal culture, history and identity is evident internally and in the larger community. Redding Rancheria is a leader in the constructive development of its people, the larger Indian community and the Redding region.
E-Verify Statement
Redding Rancheria participates in the Electronic Employment Verification Program. To learn more about E-Verify please visit https://www.e-verify.gov/employees