The work of a Medical Coding Educator Specialists involves, but is not limited to: significant use of computers; review of Federal laws, regulations, guidance, publications, and standards; review of industry guidelines, analysis of medical coding audit data and findings; development and execution of training plans; design and development of training through storyboards and other methods to create training presentations; audience analysis; delivery of training through various communication methods; evaluation and recommendation on commercial coding training; evaluation and reporting of training projects; review of significant amounts of clinical documentation; and individual and group interaction with a wide variety of DHA audiences.
This position is 100% remote.
Required Skills /Mandatory Knowledge:
- Advanced knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM), and Procedural Coding System (PCS); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT).
- Advanced knowledge of medical terminology, anatomy, physiology, disease processes, medical and surgical procedures, and including accepted medical abbreviations to perform the full scope of inpatient coding, including inpatient discharges, surgical cases, diagnostic studies and procedures, and inpatient professional services and facility encounters.
- Advanced knowledge of medical coding processes, procedures, regulations, guidelines, and principles to complete routine and non-routine medical record examination and coding tasks.
- Write in a clear and convincing manner for the intended audience; use correct English grammar, punctuation, and spelling; communicate information (for example, facts, ideas, or messages) in a succinct manner; produce written information, which may include technical material, that is appropriate for the intended audience.
- Skill in examining and extracting written and numerical data from medical documentation, to draw conclusions and generate reports based on factual documentary evidence to apply appropriate codes and identify documentation inconsistencies.
- Ability to utilize medical computer software programs to abstract, analyze, and/or evaluate clinical documentation and enter/edit diagnosis and procedure codes.
- Ability to communicate clearly and effectively, verbally and in writing, problems, conclusions, and coding guidance to individuals and groups at a variety of levels; defining target audiences and tailoring communications and messaging to target audience.
- Ability to develop new insights into situations and applies new solutions to problems, working with others to develop, test, and implement new ideas, innovations, and methods to continuously improve coding accuracy and clinical documentation.
- Advanced knowledge of medical specialties; medical diagnostic and therapeutic procedures; ancillary services (includes, but is not limited to, Dental, Laboratory, Occupational Therapy, Physical Therapy, and Radiology).
- Thorough understanding of Government rules and regulations regarding medical coding, reimbursement guidelines, and healthcare fraud; commercial reimbursement guidelines and policies; coding audit principles and concepts. Includes, but is 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 HHS-OIG publications and reports.
- Intermediate knowledge of auditing concepts and principles.
- A minimum of ten years of medical coding and/or auditing experience in two or more medical, surgical, and ancillary specialties within the past 15 years, including at least 5 years of experience in an auditing, training, or compliance role OR A minimum of three years’ auditing, training, or compliance experience within the last six years in a military coding environment.
- When claiming medical coding experience, a minimum of one (1) year of performance in the specialty is required to be qualifying. Multiple specialties encompass different medical specialties (i.e., Family Practice, Pediatrics, Gastroenterology, OB/GYN, etc.) that utilize ICD, E&M, CPT, and HCPCS codes. Ancillary specialties (PT/OT, Radiology, Lab, Nutrition, etc.) that usually do NOT use E&M codes do not count as qualifying experience. Coding experience limited to making codes conform to specific payer requirements for the business office (insurance billing, accounts receivable) is not a qualifying factor.
- When claiming training experience, training expertise must include identifying coding training opportunities, developing training plans and material, and instruction/delivery of the training to medical coder and clinical audiences.
- Coding, auditing, and training exclusively for specialties such as home health, skilled nursing facilities, and rehabilitation care will not be considered as qualifying auditing experience.
**** Medical coding personnel shall maintain the required continuing education hours in order to maintain current and proper national certification (requirements for this position.
Medical Coding Certifications:
Coding certifications in good standing for each of the following is preferred. However, SAIC will consider applicants who have at least ONE of the certifications and are willing to obtain additional certifications.
1. RHIT or RHIA or CPC or CCS-P
2. RHIT or RHIA or CIC or CCS
3. CDEO or CDEI or ACDIS or CCDS or CCDS-O or CDIP
* The AHIMA RHIT or RHIA credential may be counted toward 1. Or 2. but not both unless the individual possesses the required institutional AND professional services experience for the specific position sought.
Selected applicant must do the following before starting, based on government requirements:
- Pass a pre-employment coding test IAW the requirements of the AFMS Coding Manual.
- Provide proof of specific vaccinations and CPR training that is required to work at the facility
- The selected applicant will be subject to a government security investigation and must meet eligibility requirements
Target salary range: $50,001 - $75,000. The estimate displayed represents the typical salary range for this position based on experience and other factors.
Covid Policy: SAIC does not require COVID-19 vaccinations or boosters. Customer site vaccination requirements must be followed when work is performed at a customer site.
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