Hampton, VA US
DUTIES OF THE MEDICAL CODER-OUTPATIENT:
- Have practical knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT).
- The coder must have practical knowledge of the reimbursements systems, including but not limited to, Ambulatory Payment Classifications (APCs); and the Resource-Based Relative Value Scale (RBRVS).
- Must have practical knowledge of industry nomenclature; medical and procedural terminology; anatomy and physiology; pharmacology; and disease processes.
- The practical knowledge of medical specialties must include: medical diagnostic and therapeutic procedures; ancillary services (which includes but is not limited to, Laboratory, Occupational Therapy, Physical Therapy, and Radiology); and revenue cycle management.
- Accurately assigns diagnosis, procedure, and supply codes for the professional and institutional (facility) components of outpatient encounters in accordance with Defense Health Agency and Air Force Medical Services MCPO completeness, productivity, and timeliness standards.
- 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 the 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 could cause inaccurate coding, medico-legal re-percussions or impacts quality patient care.
- 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 query in accordance with established 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. May educate and provide feedback to providers and other clinical staff to resolve documentation issues to support coding compliance. Assigns accurate codes to encounters based upon provider responses to queries and reports all queries and responses in accordance with established guidelines.
- Utilize military healthcare computers to remotely access patient records and assign codes for patient encounters. Perform limited focused audits or peer reviews.
- Provides or contributes to periodic reports and may provide limited assistance to the facility s data quality, group practice managers, or other facility business functions.
- Associate s Degree or higher in Health Information Management; OR a certificate from an university in medical coding; OR at least 30 hours of university/college credit that includes relevant coursework such as anatomy/physiology, medical terminology, health information management, and/or pharmacology; OR successful completion of an American Academy Health Information Management Association (AHIMA) coding certification preparation course for professional services or facility coding that includes medical terminology, anatomy/physiology, health information management concepts, and pharmacology.
- Three years of medical coding and/or auditing experience in at least two or more medical, surgical and ancillary specialties within the last 10 years. A minimum of one year of performance in the specialty is required to be considered qualifying.
- 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.
- Possess either the Certified Professional Coder (CPC) or Certified Coding Specialist-Physician (CSS-P), this will satisfy the certification needed from the Professional Services Coding Certifications.
- Possess either the National Alliance of Medical Auditing Specialists (NAMAS) or the Certified Evaluation and Management Auditor (CEMA). This will satisfy the Evaluation and Management (E&M) Auditor Certification.
- Current BLS
- Must be a U.S. Citizen (for access to Government computer systems)
- Competitive pay
- 10 days paid time off per year plus 7 sick days per year
- 10 paid Federal holidays
- Health & Welfare allowance mostly covers the cost of health insurance, long and short-term disability, and life insurance
- Dental and vision plans offered, 401(k)
The Arora Group is an award-winning, Joint Commission-certified nationwide healthcare services company that, for almost 30 years, has provided medical care for the men and women who serve our country in the U.S. Armed Forces. Our mission is to provide world-class care and give our healthcare professionals opportunities to improve their skills, learn from the best, and serve the needs of active duty service members, their families, and veterans.
EOE AA M/F/Vet/Disability