Remote Medical Coder II - APV - Avosys Technology, Inc.

• 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 it 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.   

• 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 MHS guidance. 

• Acts as a source of reference to medical staff that have 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. Responsible for assignment of accurate E&M, ICD, CPT and HCPCS codes and modifiers from medical record documentation into the Government computer systems.  

• Supports MHS 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 MHS-MCPB. 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 MHS coding compliance requirements regarding training and reporting of potential violations.   

Job responsibilities are subject to change to meet Military Treatment Facility requirements.  Additional immunization record, security and background check requirements are also considered as qualifying criteria. 

EDUCATION:The Ambulatory Procedure Medical Coder will possess post-high school education or training from ONE of the following: 

• An Associate’ degree or higher in Health Information Management or Healthcare Administration, healthcare related major, or biological science; OR 

• A University certificate in medical coding; OR  

• At least 30 semester 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 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; OR  

• Successful completion of a training course beyond apprentice level for medical technicians, hospital corpsmen, medical service specialists, or hospital training, obtained in a training program given by the Armed Forces or the U.S. Maritime Service under close medical and professional supervision. 

EXPERIENCE: 

• Possess a minimum of four (4) years of medical coding and/or auditing experience in two (2) or more medical, surgical, and ancillary specialties within the past 10 years;  

• OR a minimum of two (2) years of medical coding or auditing experience if that experience was in an Military Treatment Facility (MTF). A minimum of one (1) year of performance in the specialty is required to be qualifying. 

MEDICAL CODING CERTIFICATIONS: 

This position requires possession pf a current coding certification in good standing from EACH of the following categories:  

• Professional Services Coding Certifications: ONE of the following recognized professional coding certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Professional Coder (CPC); or Certified Coding Specialist – Physician (CCS-P). 

• Institutional (Facility) Coding Certifications: ONE of the following recognized institutional coding certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Outpatient Coder (COC), or Certified Coding Specialist (CCS). Other institutional coding certifications will be considered by the MHS-MCPB on a case-by-case basis. 

KNOWLEDGE SKILLS & ABILITIES: 

• Excellent computer/communication skills for provider and staff interactions. 

• Knowledge of anatomy/physiology and disease process, medical terminology, coding guidelines (outpatient), documentation requirements, familiarity with medications and reimbursement guidelines; and encoder experience. 

• The ability to handle multiple projects and appropriately prioritize tasks to meet deadlines. 

• Knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT), as used in institutional and professional services medical coding.  

• Knowledge of reimbursement systems, including Prospective Payment System (PPS); Ambulatory Payment Classifications (APCs); and Resource-Based Relative Value Scale (RBRVS).  

• 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, Dental, Occupational Therapy, Physical Therapy, and Radiology);and revenue cycle management concepts related to medical coding.  

• Practical knowledge and understanding of Government rules and regulations regarding medical coding, reimbursement guidelines, and healthcare fraud; commercial reimbursement guidelines and policies; coding audit principles and concepts, and potential areas of risk for fraud and abuse. Includes, but not limited to: The Federal Register, Center for Medicare, and Medicaid Services (CMS) Local Coverage Determinations and National Coverage Determinations (LCD and NCD), National Correct Coding Initiative (NCCI) guidance, manual, and edits, Internet-Only Manuals (IOMs), and HHSOIG publications and reports. 

 DESIRED: 

• Experience within MHS GENESIS and other military coding systems to complete encounters.