Health - Data Entry Clerk

Under the direction of the Billing Office Manager, the Data Entry Clerk incumbent performs highly technical and specialized functions for the Tribal Health Clinic. The employee reviews, audits, and codes diagnostic and procedural information that assures completeness and accuracy of the visits in the Electronic Health Record and the Resource Patient Management System (RPMS) and assures third party reimbursement. The primary function of this position is to perform ICD-9 CM, CPT and HCPCS coding for reimbursement for all documented encounters. The coding function is a primary source for data and information used in health care today and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.

ESSENTIAL FUNCTIONS: (includes, but is not limited to, the following)

• Performs comprehensive review of the visit record to assure presence of all component parts.
• Evaluates the Electronic Health Record visit documentation for consistency and adequacy. Ensures that diagnosis accurately reflects treatment rendered.
• Provides back-up coverage to Patient Registration staff.
• Audits and/or corrects ICD-9 and CPT codes for billing third party resources.
• Reviews each encounter, identifying deficiencies, documenting and reporting operational difficulties to appropriate supervisor.
• Responsible for various data clean-up projects as assigned by supervisor.
• Directly participates with medical, dental, laboratory, radiology, audiology, pharmacy and nursing staff to clarify documentation in EHR.
• Merge pharmacy visits and enter missing information.

ADDITIONAL RESPONSIBILITIES: (includes, but is not limited to, the following)

• May help in other departments within the clinic such as scheduling, registration and Program Clerk duties
• All other job-related duties as assigned.

CONTACTS:

Immediate peers, peers in other departments, immediate supervisor/manager, managers in other departments, physicians, nurses and customers.

PHYSICAL REQUIREMENTS:

Position sedentary, primarily sitting/lifting of maximum of 10 pounds. Constantly sitting, using near vision and typing. Frequently hearing and use of midrange and far vision. Occasionally noise, standing, walking, carrying, lifting, climbing, stooping, reaching, manual handling, depth perception, color vision, field of vision and bending. Constant patient contact and/or client contact. Constant computer use. Frequent infectious exposure and occasional equipment use.

EDUCATION AND EXPERIENCE:

Education: High school diploma or equivalent required.

Experience: Minimum of 1-year experience required.

Certification/License: Must maintain a good moral character standing. Will be required to complete and pass pre-employment drug testing.

Knowledge, Skills and Abilities: Knowledge of Medical terminology and ICD-9 and CPT codes preferred. Knowledge of RPMS/Electronic Health Record required. Knowledge and skill sufficient to decipher terminology and abbreviations used by providers preferred. Ability to use medical references independently preferred. Proficient use of computer required. Must have excellent communication skills and be able to communicate clearly in person, in writing, and by telephone and email. Must maintain strict confidentiality. Native American preferred.