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Medical Coding Compliance Specialist

Job ID: 1924059
Location: EGLIN AFB, FL, United States
Date Posted: Oct 10, 2019
Category: Environmental, Health & Safety
Subcategory: Medical Coder
Schedule: Full-time
Shift: Day Job
Travel: Yes, 10 % of the Time
Minimum Clearance Required: None
Clearance Level Must Be Able to Obtain: None
Potential for Teleworking: No

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Job Description

Description

SAIC is seeking a Medical Coding Compliance Specialist, who takes pride in their work, to contribute to the continued success of our DHA programs at Eglin AFB in FL. In this role you will:

  • Providing analysis and auditing of medical coding 

  • Investigating and resolving issues and variance with policy

  • Make compliance and process related recommendations on medical coding issues

  • Provide research, and other support services to ensure observance with official coding policies, regulations, requirements, and standards

  • Ensure revenue integrity consists by providing analysis, auditing, investigation, recommendations, research, and other support to prevent lost revenue from healthcare operations

  • Participate in process improvement efforts by maintaining a weekly issues log in accordance with the AFMS Coding Manual, to be received by the AFMS MCPO

  • Take required continuing education classes in order to maintain current and proper national certification(s) requirements for this position

  • Apply your 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      

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

Qualifications

 
Education: 

·      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; OR Completion of American Health Information Management Association (AHIMA) and/or American Academy of Professional Coders (AAPC) exam preparation courses. Coding certification may be accepted in lieu of university credit.

Experience:

·     10 or more years of medical coding and/or auditing experience in two or more medical, surgical, and ancillary specialties 

·     At least 5 years of experience training auditors, coders, and/or providers, or a minimum of 3 years of training experience in a military coding environment.

 

·       Coding certification in good standing from each of the following:

  • Professional Services Coding 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

  • Compliance Certifications: Certified Professional Compliance Officer (CPCO) from AAPC; Certified in Healthcare Compliance (CHC) or Certified Compliance & Ethics Professional (CCEP) from the Healthcare Compliance Association (HCCA). Other compliance certifications will be considered by the AFMS MCPO

     

·     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

  • Selected applicant will be subject to a government security investigation and must meet eligibility requirements to obtain and maintain NACI clearance 


Desired Qualifications

 

Knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM), & Procedural Coding System (PCS); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT).

Advanced 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).

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, Radiology; revenue cycle management.)



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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