Join the Indian Health Service and make a meaningful impact in Native communities. In this role, you will support vital healthcare operations that help ensure patients receive timely, high-quality care.
A REAL ID will be required beginning May 7, 2025, in accordance with 6 C.F.R. 37.5 (2021).
Duties
- Review medical records for completeness, including required identifiers, signatures, dates, and reports associated with services rendered.
- Evaluate documentation for accuracy, consistency, medical necessity, and appropriate modifier usage.
- Verify that final diagnoses accurately reflect care provided.
- Review provider documentation to ensure appropriate Evaluation and Management (E/M) levels and correct CPT code assignment.
- Assign and sequence ICD, CPT, HCPCS, CDT, and DSM codes based on documented diagnoses and procedures.
- Ensure diagnostic and procedural terminology aligns with current medical nomenclature and official coding guidelines.
Requirements & Qualifications
Qualifications
- GS-07: 1 year of specialized experience equivalent to the GS-06 level in federal service, or equivalent private/public sector experience.
- Experience verifying documentation supporting diagnoses, treatments, procedures, and services rendered while maintaining compliance with coding standards, privacy regulations, and organizational policies.
- Experience initiating and monitoring documentation clarification requests to obtain diagnosis specificity, procedure details, and supporting clinical information for accurate coding and reporting.
- Experience assisting providers and clinical staff with documentation requirements, coding guidelines, and common deficiencies affecting reimbursement and quality measures.
- Experience participating in coding reviews, compliance audits, and performance improvement activities to evaluate documentation quality, coding accuracy, and reimbursement outcomes.
- Experience analyzing coding trends, denial patterns, and documentation issues and recommending process improvements.
- Certified Professional Coder (CPC) preferred.
- No education requirements.
Conditions of Employment
- Selectee may be subject to a probationary period.
- U.S. citizenship is required.
- Selective Service registration is required for males born after 12/31/1959.
- Must successfully pass E-Verify.
- Must complete a federal background investigation.
- Financial suitability review is required.
- Must provide two valid forms of identification prior to appointment.
Benefits & Perks
Benefits
- U.S. government employee benefits package.
- Federal benefits coverage for employees and eligible family members.
- Total compensation package offered by Indian Health Service.
Location
South Dakota, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago
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