Job ID: 1924059
Location: EGLIN AFB, FL, United States
Date Posted: Oct 10, 2019
Category: Environmental, Health & Safety
Subcategory: Medical Coder
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
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.
· 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.
· 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
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.)
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