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Medical Coder 3

Job ID: 2115947
Location: SAN ANTONIO, TX, United States
Date Posted: Dec 2, 2021
Category: Environmental, Health & Safety
Subcategory: Medical Coder
Schedule: Full-time
Shift: Day Job
Travel: No
Minimum Clearance Required: None
Clearance Level Must Be Able to Obtain: None
Potential for Remote Work: Yes
Benefits: Click here

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Job Description

Description

Accurately assigns diagnosis, procedure, and supply codes for the professional and institutional (facility) components of Inpatient, External Resource Sharing Agreement (ERSA), Ambulatory Procedure Visit (APV), Observation, Emergency Department (ED), and Outpatient encounters. Codes assigned include International Classification of Diseases, Clinical Modification (ICD-CM), International Classification of Diseases, Procedural Classification System (PCS), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and modifiers. Uses military computer systems to assign, edit, and review codes. Applies knowledge of medical terminology, anatomy and physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the principles and practices of health services and the organizational structure to ensure proper code selection. Adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or Evaluation and Management code to ensure ethical, accurate, and complete coding. Monitors ever-changing regulatory and policy requirements affecting coded information for the full spectrum of services provided.

Qualifications

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.

 Education/Certification Requirements:

 Education: A 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.

Education in section must be from an accredited educational institution recognized by the American Health Information Management Association (AHIMA) and/or American Academy of Professional Coders (AAPC).

 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 a 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.

 Experience: A 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. . 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. 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.

Must have a total of 9 years of relevant experience

 Coding Test. Pass a pre-employment coding test 



COVID Policy: Prospective and/or new employees are required to adhere with SAIC's vaccination policy. All SAIC employees must be fully vaccinated and they must submit proof of vaccination on their first day of employment. Prospective or new employees may seek an exemption to the vaccination requirement at Contact Us and must have an approved exemption prior to the start of their employment. Where work is performed strictly at a customer site, customer site vaccination requirements preempt SAIC's vaccination policy.
Target salary range: $50,001 - $75,000. The estimate displayed represents the typical salary range for this position based on experience and other factors.


Overview

SAIC® is a premier Fortune 500® technology integrator driving our nation's technology transformation. Our robust portfolio of offerings across the defense, space, civilian, and intelligence markets includes secure high-end solutions in engineering, digital, artificial intelligence, and mission solutions. Using our expertise and understanding of existing and emerging technologies, we integrate the best components from our own portfolio and our partner ecosystem to deliver innovative, effective, and efficient solutions that are critical to achieving our customers' missions.

We are more than 26,500 strong; driven by mission, united by purpose, and inspired by opportunities. SAIC is an Equal Opportunity Employer, fostering a respectful work culture based on diversity, equity, and inclusion that values all contributors. Headquartered in Reston, Virginia, SAIC has annual revenues of approximately $7.1 billion. For more information, visit saic.com.

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