Medical Coder

Akahi Associates LLC
Annapolis, MD
Apr 03, 2021
Apr 10, 2021
Full Time
Outpatient Medical Coder Location: Naval Health Clinic Annapolis located at 695 Kinkaid Road, Annapolis, MD 21402 Work Schedule: Monday through Friday for eight (8) hours daily (flex-schedule between 0700 and 1700) excluding a non-billable lunch hour. The Government does not support "comp hours" or "make up hours" as it negatively impacts oversight responsibilities. Qualifications: Outpatient Medical Coder - An Associate's degree or higher in Health Information Management; A university certificate in medical coding; At least 30 semester hours' university/college credit that includes relevant coursework such as anatomy/physiology, medical terminology, health information management, and/or pharmacology. Successful completion of an American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) coding certification preparation course for professional services or facility coding that includes medical terminology, anatomy and physiology, health information management concepts, and pharmacology. Experience Outpatient Medical Coder - MSS personnel in this position are required to possess a minimum of three (3) years of medical coding and/or auditing experience in two (2) or more medical, surgical and ancillary specialties within the past 10 years. A minimum of one (1) year of performance in the specialty is required to be qualifying. Other Knowledge, Skills and Abilities Outpatient Medical Coder - Practical knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT). Practical knowledge of reimbursement systems, including, but not limited to, Ambulatory Payment Classifications (APCs); and Resource-Based Relative Value Scale (RBRVS). Practical knowledge and understanding of industry nomenclature; medical and procedural terminology; anatomy and physiology; pharmacology; and disease processes. Practical knowledge of medical specialties; medical diagnostic and therapeutic procedures; ancillary services (includes, but is not limited to, Laboratory, Occupational Therapy, Physical Therapy, and Radiology); and revenue cycle management. Coding Certifications: Note: A Registered Health Information Technician (RHIT) and Registered Health Information Administrator (RHIA) from AHIMA are acceptable to count for either a professional services coding certification or institutional coding certification, but not both. Outpatient Medical Coding - MSS personnel in this position are required to possess a current coding certification in good standing from EACH of the following categories: Professional Services Coding Certifications: The following are recognized professional certifications: Certified Professional Coder (CPC) or Certified Coding Specialist - Physician (CCS-P). Evaluation and Management (E&M) Auditor Certification: National Alliance of Medical Auditing Specialists (NAMAS) Certified Evaluation and Management Auditor (CEMA). Coding Test - Contractor employees must achieve a minimum 70% passing score and the candidate's score must be reported in the qualification documents by the Contractor. An incumbent employee who has previously passed a test approved by the AFMS MCPO may be exempted from this requirement. Performance Outcomes Outpatient Medical Coder - Accurately assigns diagnosis, procedure, and supply codes for the professional and institutional (facility) components of Outpatient encounters IAW DHA and AFMS MCPO completeness, productivity, and timeliness standards. Also, provides or contributes to periodic reports IAW DHA and AFMS MCPO instructions and timelines. Adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or Evaluation and Management code to ensure ethical, accurate, and complete coding. Monitors ever-changing regulatory and policy requirements affecting coded information for the full spectrum of services provided. Maintains technical currency through continuing education and training opportunities. Reviews encounter and/or record documentation to identify inconsistencies, ambiguities, or discrepancies that may cause inaccurate coding, medico-legal re-percussions or impacts quality patient care. Identifies any problems with legibility, abbreviations, etc., and brings to the provider's attention. May perform assessments and examine records for proper sequence of documents, presence of authorized signatures, and sufficient data is documented that supports diagnosis, treatment administered, and results obtained. Develops and submits a written (electronic or hard copy) query IAW DHA or AFMS MCPO guidelines to the provider to request clarification of provider documentation that is conflicting, ambiguous, or incomplete in regards to any significant reportable condition or procedure. Monitors query submission, response times, and completion. Educates and provides feedback to providers and clinical staff to resolve documentation issues to support coding compliance. Assigns accurate codes to encounters based upon provider responses to queries and reports queries and responses IAW DHA or AFMS MCPO guidance. Acts as a source of reference to medical staff having questions, issues, or concerns related to coding. Responds to provider questions and provides examples of appropriate coding and documentation reference(s) to provide clarity and understanding. Based on contacts from the medical staff identifies training opportunities and works with coding training personnel to focus on consistency and clarity of coding advice provided. Collaborates with Medical Coding Trainers in developing, delivering, and monitoring initial and annual coding training to providers and clinical staff by providing guidance to professional and technical staff in documentation requirements for coding. Supports DHA and AFMS coding compliance by performing due diligence in ethically and appropriately researching and/or interpreting existing guidance, including seeking clarification from the Lead Medical Coder, supervisor, or Service coding representatives. May perform focused audits of specific MTFs, medical specialties, clinics, coders, or providers as directed and IAW DHA and/or AFMS audit procedures. Performs administrative related tasks associated with medical records final reviews/audits and contacting various departments, services, or medical staff to obtain data needed to complete the records. Complies with DHA and/or AFMS coding compliance requirements regarding training and reporting of potential violations. May assist with MTF initial and annual coding compliance training and tracking MTF coding compliance training. The entry and transmittal of patient and coding data through different Government computer systems will sometimes be flagged for errors (known as "write-back errors"). Write-back errors are corrected by the MTF staff or coders and tracked through corrective action. Write-back errors generated by a patient administration error (for example, incorrect or missing demographic information) is corrected by the MTF Patient Administration section. The medical coder may be used to correct all write-back errors caused by coding errors. Upon DHA or AFMS MCPO direction, utilizes MHS computer systems to remotely access patient records and assign codes for patient encounters in support of other MTFs. Perform, limited focused audits of MTFs, specialties, clinics, or providers conducted, or Quality Assurance (QA) or peer reviews, IAW DHA requirements. If DHA requirements are not available at the time of award of this contract, all focused audits, QA, or peer reviews will be conducted IAW AFMS MCPO instructions. Coding validation notifications (aka "CAPER" validations) are reports of certain diagnosis codes which may need further investigation and provider clarification. These areas may include smallpox, anthrax, abortions, flu, hepatitis, TB and others as designated as a Congressional, DHA, or AFMS MCPO reporting requirement. The coder will review coding validation notifications from the AFMS MCPO and ensure that identified codes are correct, making corrections when necessary. Encounters should be corrected within three business days and providers receive training on the consequences of the use of the codes assigned. Provides or contributes to periodic reports IAW DHA and AFMS MCPO instructions and timelines. May provide limited assistance as necessary to the MTF Data Quality, Group Practice Managers, or other MTF business functions in compiling, analyzing, and reporting MTF coding data for performance purposes. Physical Requirements - None. Kahua LLC Kahua Services is a premier provider of healthcare workers to various military treatment facilities across the United States. With a corporate office in Honolulu, Hawaii and recruiting office in San Antonio, Texas we specialize in providing skilled, trained and highly successful healthcare workers, including RNs,CRNAs, Physicians, LPN/LVN, Licensed Social Workers, and many more. We have a strong focus on providing our government customers with quality and superior service. Kahua Services is an equal opportunity employer and Minorities, Females, Veterans, and Disabled persons are encouraged to apply. For further information, please click the link below to view the EEO Is The Law poster. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. Only qualified individuals who are being considered will be contacted for an interview Years Experience: 1 - 3 years Bonus/Commission: No

Similar jobs