Job Summary:
GENERAL DESCRIPTION
The Coder and Billing Educator provides training, auditing, and support to Cherokee Nation Health Services staff and providers to promote accurate coding, compliant documentation, and proper billing practices.
Job Duties:
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Develops, delivers, and evaluates training programs for new and existing staff related to revenue cycle processes, documentation standards, and compliance requirements.
- Creates educational materials, job aids, reference guides, and workflow documentation tailored to departmental needs.
- Conducts routine and targeted audits to assess accuracy, completeness, and compliance with organizational, payer, and regulatory standards.
- Identifies trends, errors, and opportunities for improvement and provides timely feedback and corrective education.
- Serves as a subject‑matter resource for staff and providers regarding documentation, compliance, and department‑specific workflows.
- Collaborates with Revenue Cycle, Compliance, Quality, and operational leadership to support accuracy, reduce denials, and improve overall performance.
- Maintains current knowledge of CMS regulations, payer policies, and industry best practices.
- Supports onboarding and competency development for new hires and cross‑training initiatives for existing staff.
- Assists in developing and updating policies, procedures, and training materials related to coding, billing, and documentation.
- Participates in performance improvement initiatives and contributes to organizational compliance efforts
- Other duties as assigned.
ADDITIONAL DUTIES AND RESPONSIBILITIES
- Provides education on billing workflows, payer rules, claim submission requirements, and organizational billing practices.
- Conducts billing audits to ensure claims are accurate, complete, and compliant with payer and regulatory guidelines.
- Trains new staff and other departments on billing practices specific to Cherokee Nation Health Services and tribal health system requirements.
- Reviews claim errors, rejections, and denials to identify trends and provide corrective training.
- Supports billing staff in resolving complex billing issues, payer edits, and claim submission challenges.
- Communicates payer updates, billing rule changes, and regulatory requirements to staff.
- Collaborates with billing leadership to improve clean claim rates and reduce billing‑related denials.
LEVEL OF RESPONSIBILITY
- Performs work under minimal supervision.
- Handles complex issues and problems, and refers only the most complex issues to higher-level staff.
- Possesses comprehensive knowledge of subject matter.
Qualifications:
QUALIFICATIONS
- Associate degree in Health Administration, Health Information Management, or a related field; or an equivalent combination of education and experience.
- At least three (3) years of experience in medical coding, medical billing or a related healthcare field required.
COMPETENCIES
- Ability to develop and mentor others.
- Leadership skills.
- Oral and written communication skills.
- Ability to build collaborative relationships.
- Ability to identify and seek needed information/Research skills.
- Analytical thinking skills.
- Conceptual thinking skills.
- Technical expertise.
- Ability to meet deadlines.
- Project management skills.
PHYSICAL REQUIREMENTS
- While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms; climb or balance and talk or hear. The employee is frequently required to stand and walk. The employee is occasionally required to stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
CERTIFICATES, LICENSES, REGISTRATIONS
- Must possess a valid driver's license with a driving history verified through a motor vehicle report that meets requirements for Cherokee Nation underwriting rating.
- Certified Professional Biller (CPB) or equivalent credential in medical billing is preferred but not required; any licensure held must be maintained throughout employment.
OTHER REQUIREMENTS
- The employee must not be and will not be under sanction by the United States Department of Health and Human Services Office of the Inspector General (OIG) or by the General Services Administration (GSA) or listed on the OIG's Cumulative Sanction Report, or the GSA's List of Excluded Providers, or listed on the OIG's List of Excluded Individuals/Entities (LEIE).
