Job ID: 2119022
Location: SAN ANTONIO, TX, United States
Date Posted: Dec 13, 2021
Category: Environmental, Health & Safety
Subcategory: Medical Coder
Shift: Day Job
Minimum Clearance Required: None
Clearance Level Must Be Able to Obtain: None
Potential for Remote Work: Yes
Benefits: Click here
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.
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: 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
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