Medical Coder

The Medical Coderreviews clinical documentation and assigns accurate International Classification of Diseases, Tenth Revision (ICD 10), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), Code on Dental Procedures and Nomenclature (CDT), and modifier codes for medical, dental, behavioral health, pharmacy, Purchased/Referred Care (PRC), and ancillary services. This role supports compliant billing, reimbursement optimization, and documentation accuracy across Kahtnuht’ana Development Corporation (KDC) operations, including all awarded proposals, Indian Health Service (IHS) contracts, and Tribal health system requirements. 

PRINCIPAL ACTIVITIES & RESPONSIBILITIES

• Review documentation and assign accurate codes across all service lines.
• Ensure compliance with Medicare, Medicaid, commercial payer, Indian Health Service (IHS), and Tribal billing requirements.
• Identify documentation gaps and communicate with providers for clarification.
• Support charge entry, claim readiness, and reimbursement workflows.
• Assist with denial management and coding related corrections.
• Monitor coding updates and regulatory changes.
• Participate in internal audits and compliance reviews.
• Support training and documentation improvement initiatives.
• Maintain productivity and accuracy standards.
• Collaborate with clinical, billing, and operational teams to improve workflows.
• Validate documentation for medical necessity and alignment with payer policies, including IHS and Tribal program requirements.
• Ensure coding accuracy for Prospective Payment System (PPS), All Inclusive Rate (AIR), and wrap around reimbursement submissions.
• Assist in maintaining charge master accuracy and alignment with fee schedules and EHR configuration.
• Support coding quality improvement efforts tied to federal contract deliverables, grants, and proposal requirements.
• Travel up to 40%.

QUALIFICATIONS

• High school diploma required; HIM or related education preferred.
• Minimum 2 years coding experience.
• Coding certification required: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), Registered Health Information Technician (RHIT)
• Knowledge of Tribal health, IHS, Federally Qualified Health Center (FQHC) billing preferred.
• Experience coding across multiple service lines (medical, dental, behavioral health, pharmacy, PRC, ancillary) preferred.
• Familiarity with Electronic Health Record (EHR) systems used in Tribal/IHS environments (e.g., Resource and Patient Management System (RPMS), Cerner, Epic).
• Understanding of documentation requirements for value based care, Alternative Payment Models (APMs), and federal reimbursement programs.

PHYSICAL REQUIREMENTS

Physical job requirements encompass a range of activities that may be necessary for various roles. These can include, but are not limited to:

• Lifting and Carrying: Ability to lift and transport objects up to 25 pounds occasionally.
• Standing and Walking: Position may require prolonged periods of standing or walking.
• Bending and Stooping: Ability to bend, stoop, and crouch as needed.
• Reaching and Pushing/Pulling: Ability to reach for items and move office equipment as necessary.
• Sitting: Ability to sit for extended periods while performing administrative and computer-based work.

EQUAL OPPORTUNITY & TRIBAL PREFERENCE STATEMENT

Kahtnuht’ana Development Corporation (KDC) is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other protected status.

In accordance with applicable federal law, preference will be given to qualified Kenaitze Indian Tribe members.