The Certified Coder performs highly technical and specialized medical coding functions for Cherokee Indian Hospital Authority. This role reviews, analyzes, and codes diagnostic and procedural information used for Medicare, Medicaid, and private insurance reimbursement.

The position focuses on accurate ICD-10-CM, CPT, and HCPCS coding, ensuring compliance with coding guidelines, reimbursement policies, regulations, and accreditation requirements.

Key duties include:

Assigning and sequencing ICD-10-CM, CPT, and HCPCS codes for diagnoses and procedures
Verifying that final diagnoses and operative procedures are valid and complete
Abstracting information from medical records to identify secondary complications and comorbid conditions
Ensuring codes accurately reflect documented diagnoses, surgical procedures, and therapies
Reviewing provider documentation to assign appropriate Evaluation & Management levels
Performing quantitative and qualitative record analysis for completeness, consistency, and compliance
Using RPMS and EHR systems to update patient information and export data as needed
Following safety procedures and tribal policy
Performing other assigned duties