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Coding Team Lead (MC Coder III)

Job ID: 192289
Location: ANCHORAGE, AK, United States
Date Posted: Oct 10, 2019
Category: Environmental, Health & Safety
Subcategory: Medical Coding Trainer
Schedule: Full-time
Shift: Day Job
Travel: Yes, 25 % of the Time
Minimum Clearance Required: NACI
Clearance Level Must Be Able to Obtain: None
Potential for Teleworking: No

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Job Description

Description

 

SAIC is looking to hire a Lead Medical Coder at Elmendorf military hospital in Anchorage, Alaska. In addition to coding duties, this individual will be the single point of contact for SAIC, the other contracted coding professionals and the Government; thus, this individual serves as a liaison with coworkers and the company for the Contracting Officer Representative. Delegation of the lead coder position and any supervisory responsibilities will be at the company’s discretion.

Examples of lead coder tasks include, but are not limited to:

  • Coordinating contract coder leave requests with the CM and contractor management staff to ensure appropriate coverage

  • Assisting the CM in distributing and monitoring workload assignments

  • Acting as a POC for Hub contract coders to route questions/concerns to appropriate channels (CM, contractor management staff)

  • Performs peer review functions on contract coders IAW MTF task order QASP

  The Lead Medical Coder is also responsible for monitoring:

  • Production

  • Individual Development Plans

  • Liaison Tasks

  • Personnel Issues

The primary duties of a Medical Coder III are to review clinical documentation and assign medical codes for inpatient facility and/or professional services; however, Medical Coder III personnel may be tasked to assign medical codes for facility and/or professional services for ambulatory surgery, observation, emergency department, or outpatient clinic services. 

Knowledge and Skills:

  • 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). 

  • Practical knowledge of reimbursement systems, including Prospective Payment System (PPS) and Diagnostic Related Groupings (DRGs); Ambulatory Payment Classifications (APCs); and Resource-Based Relative Value Scale (RBRVS).

  • Advanced knowledge and understanding of industry nomenclature; medical and procedural terminology; anatomy and physiology; pharmacology; and disease processes.

  • Advanced knowledge of medical specialties; medical diagnostic and therapeutic procedures; ancillary services (includes, but is not limited to, 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, and potential areas of risk for fraud and abuse. 

  • Practical knowledge of revenue cycle management, project management concepts, business analysis, training methods, clinical documentation improvement, and continuous process improvement processes. 

 

Qualifications

  • Minimum of 5 years of medical coding and/or auditing experience in 2 or more medical, surgical and ancillary specialties within the past 10 years. Required experience must include Medical Severity - Diagnostic Related Group (MS-DRG) assignment.

  • 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. Additionally, coding, auditing and training exclusively for specialties such as home health, skilled nursing facilities, and rehabilitation care will not be considered 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.

  • Minimum of one of the following: 

    • An associate’s degree 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 AAPC or AHIMA coding certification preparation courses that include the above coursework and lead to successful course completion and coding certification may be accepted in lieu of university/college credit by the AFMS MCPO on a case-by-case basis. 

  • Coding Certifications: Medical Coding Auditors are required to possess one certification in good standing from each of the following:

  • Professional Services Coding Certifications: The following are recognized professional certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Professional Medical Coding Auditor (CPMA); Certified Professional Coder (CPC); Certified Outpatient Coder (COC);  or Certified Coding Specialist – Physician (CCS-P).

  • Institutional (Facility) Coding Certifications:  Certified Inpatient Coder (CIC), Certified Coding Specialist (CCS). Other institutional coding certifications will be considered by the AFMS MCPO on a case-by-case basis.

  • Continuing Education Requirements: Medical coders shall maintain the required continuing education hours in order to maintain current and proper national certification(s) requirements for this position at no expense to the Government.

  • Other Requirements: Selected applicants 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 are required to work at the medical facility.

    • Applicant will be subject to a government background investigation and must meet the eligibility requirements.


Desired Qualifications

 

Overview

SAIC is a premier technology integrator, solving our nation's most complex modernization and systems engineering challenges across the defense, space, federal civilian, and intelligence markets. Our robust portfolio of offerings includes high-end solutions in systems engineering and integration; enterprise IT, including cloud services; cyber; software; advanced analytics and simulation; and training. We are a team of 23,000 strong driven by mission, united purpose, and inspired by opportunity. Headquartered in Reston, Virginia, SAIC has annual revenues of approximately $6.5 billion. For more information, visit saic.com. For information on the benefits SAIC offers, see Working at SAIC. EOE AA M/F/Vet/Disability

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