Him Coder; Otpt; Albuquerque

Job Details

Closing Date:
Monday, February 2, 2026, at 4:00 PM (MST)

Salary Range: $26.13/hr - $32.14/hr

APPLICANT MUST HAVE A VALID, UNRESTRICTED INSURABLE DRIVER’S LICENSE

RESUMES AND REFERENCES ARE REQUIRED

• Retrieves information from the RPMS in identifying the patients; and reviews medical records to insure FDIHB providers assign the correct diagnosis and procedural codes.
• Assigns and categorized codes using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), International Classification of Diseases, Tenth Revision, Procedural Coding System (ICD-10-PCS), Current Procedure Terminology (CPT), Health Common Procedure Coding System (HCPCS) Code, coding guidelines and other policies set by FDIHB, Centers for Medicare and Medicaid Services (CMS) or other regulatory organizations as related. Uses the 3M Grouper System to assist in classifying diagnoses and verifying the accuracy of coding assignments.
• Abstracts all necessary information by auditing and analyzing patient care component forms (PCC), Electronic Health record for the appropriate Evaluation and Management (E&M) levels, CPT and the HCPCS codes that accurately describe each medical/surgical procedures/supplies on each patient visit.
• Performs quantitative analysis to ensure the presence of all component parts of the record such as patient name, health record number, dates of service and time, signatures where required on paper forms and/or E.H.R. and the presence of all reports, which are indicated by the nature of the visit. Evaluates the records for internal consistency, completeness and accuracy for sufficient data to justify the diagnoses and procedures assigned.
  
  Identifies inconsistencies or discrepancies among medical documentation and discuss with appropriate staff members and physicians without infringing on decisions concerning a medical provider or physician’s clinical judgment.
• Performs quality data entry of protected patient health information into the RPMS and 3M Grouper systems, which requires extensive interaction with the RPMS-PCC system using mnemonics for entering and editing data. Performs audits and medical reviews by running error listings and/or other data reports to ensure documentation and accountability of all data. Reviews and completes zero reports where PCC plus System is in place, RPMS Audit list reporting to capture all data missed and/or errors hanging in the system in a timely manner.
• Ensures the validity, completion and disposition of all clinical records briefs reflecting encoded and other patient related information. Maintains confidentiality of health information in accordance with the Privacy Act of 1974 and Health Information Portability Accountability Act (HIPAA) of 1996, Alcohol and Drug Abuse Patient Records, Freedom of Information Act and other mandatory federal regulations.
  · Works with clinical staff in coordinating the workflow such as PCC+ system and ensuring up-to-date codes are maintained in the RPMS, and by surveying potential risk areas and identifying inconsistencies or discrepancies within the medical records and discusses with the appropriate medical, nursing, and/or healthcare providers for corrective action without infringing on decisions concerning a physician’s clinical judgment.
• Monitors specific areas as indicated for areas of improvement by recognizing potential risks subjected to compliance issues such as coding and data entry. Incumbent documents findings, prepares reports to present to immediate supervisor. Performs quality assurance/performance functions for the department to ensure qualities of services are provided. Prepares reports, presents to staff and Quality Assurance Committee as needed. Completes all RCM Queries within 24 hours upon received.
• Uses coding guidelines and resources that include the Encoder (3M), ICD-10 CM, ICD 10-PCS, CPT, HCPCS, and other coding classification systems, RPMS user’s guide, PDR, the Privacy Act, HIPPA regulations, medical dictionaries, FDIHB policies and procedures, CMS, the Revenue Cycle Management Compliance Plan, Health Records guidelines, written…