Avosys is a growing integrator of professional, technological and management solutions services. Founded in 1998, Avosys provides services nationwide to Federal, Commercial, Local and State clients. We recognize the foundation of our firm is our people and we continue to rise above our competition by hiring the best.
Is it your calling to serve our Nations Heroes? Avosys is seeking an Inpatient Medical Coder Remote to provide services to the military in El Paso, Tx.
- Maximize family time with no weekend, Holiday, or on-call requirements.
- Maintain work-life balance with guaranteed 8-hour shifts.
- Take advantage of our competitive, comprehensive benefits package including medical, dental, vision, life, short-term disability, long-term disability & 401(k)
The Lead Medical Coder will play a pivotal role in overseeing and guiding the coding operations for the government client. This position is responsible for providing leadership to the coding team, ensuring compliance with coding guidelines, and supporting the revenue cycle process. Experience with Data and reporting. The Lead Medical Coder also serve as a coder themselves, resource for staff, addressing coding inquiries, conducting training, and implementing best practices.
RESPONSIBILITIES :
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Provide ongoing education to staff regarding changes in coding guidelines and regulations.
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Experience in implementing quality assurance measures to monitor and improve coding accuracy.
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Establish and monitor key performance indicators (KPIs) related to coding efficiency and accuracy.
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Develop action plans to address any identified areas for improvement.
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Adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or E&M code to ensure ethical, accurate, and complete coding.
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Monitors ever-changing regulatory and policy requirements affecting coded information for the full spectrum of services provided.
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Maintains technical currency through continuing education and training opportunities.
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Reviews encounter and/or record documentation to identify inconsistencies, ambiguities, or discrepancies that may cause inaccurate coding, medico-legal re-percussions or impacts quality patient care. Identifies any problems with legibility, abbreviations, etc., and brings it to the providers attention. May perform assessments and examine records for proper sequence of documents, presence of authorized signatures, and sufficient data is documented that supports diagnosis, treatment administered, and results obtained.
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Educates and provides feedback to providers and clinical staff to resolve documentation issues to support coding compliance. Assigns accurate codes to encounters based upon provider responses to queries and reports queries and responses IAW MHS guidance.
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Acts as a source of reference to medical staff that have questions, issues, or concerns related to coding. Responds to provider questions and provides examples of appropriate coding and documentation reference(s) to provide clarity and understanding. Based on contacts from the medical staff, identifies training opportunities and works with coding training personnel to focus on consistency and clarity of coding advice provided.
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Collaborates with Medical Coding Trainers in developing, delivering, and monitoring initial and annual coding training to providers and clinical staff by providing guidance to professional and technical staff in documentation requirements for coding. Responsible for assignment of accurate E&M, ICD, CPT and HCPCS codes and modifiers from medical record documentation into the Government computer systems.
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Supports MHS coding compliance by performing due diligence in ethically and appropriately researching and/or interpreting existing guidance, including seeking clarification from the Lead Medical Coder, supervisor, or MHS-MCPB. Performs administrative related tasks associated with medical records final reviews/audits and contacting various departments, services, or medical staff to obtain data needed to complete the records. Complies with MHS coding compliance requirements regarding training and reporting of potential violations.
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You will accurately assign diagnosis and procedure codes for inpatient facility and professional services to include, but not limited to; inpatient stays, surgical procedures, dental surgical procedures, anesthesia services, ancillary services, and inpatient ERSA encounters in accordance with MHS completeness, productivity, and timeliness standards. Accurately assigns diagnosis and procedure codes for facility and professional services for Ambulatory Procedure Visit (APV), Dental surgical procedures, Observation, Emergency Department (ED), outpatient ERSA, and Outpatient encounters in accordance with MHS completeness, productivity, and timeliness standard.
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Work may involve areas such as Laboratory, Radiology, and Dental services. Ensures correct assignment of DRGs for inpatient stays. Codes inpatient discharge records with correct and optimal DRG assignment, Relative Weighted Product (RWP) and Relative Value Units (RVUs) in order for the Center to receive correct reimbursement or workload credit. Codes records with correct Ambulatory Payment Classifications (APCs); and Relative Value Units (RVUs) in order for the Center to receive correct reimbursement or workload credit.
Job responsibilities are subject to change to meet Military Treatment Facility requirements. Additional immunization record, security and background check requirements are also considered as qualifying criteria.
EDUCATION: The Lead Procedure Medical Coder will possess post-high school education or training from ONE of the following:
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An Associate degree or higher in Health Information Management or Healthcare Administration, healthcare related major, or biological science; OR
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A University certificate in medical coding; OR
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At least 30 semester hours of University/College credit that includes relevant coursework such as anatomy/physiology, medical terminology, health information management, and/or pharmacology; OR
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Successful completion of an American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) coding certification preparation course for professional services or facility coding that includes medical terminology, anatomy and physiology, health information management concepts, and pharmacology; OR
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Successful completion of a training course beyond apprentice level for medical technicians, hospital corpsmen, medical service specialists, or hospital training, obtained in a training program given by the Armed Forces or the U.S. Maritime Service under close medical and professional supervision.
EXPERIENCE:
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Possess a minimum of four (4) years of medical coding and/or auditing experience in two (2) or more medical, surgical, and ancillary specialties within the past 10 years;
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OR a minimum of two (2) years of medical coding or auditing experience if that experience was in an MTF. A minimum of one (1) year of performance in the specialty is required to be qualifying.
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Inpatient coding experience minimum 2 years.
MEDICAL CODING CERTIFICATIONS:
This position requires possession pf a current coding certification in good standing from EACH of the following categories:
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Professional Services Coding Certifications: ONE of the following recognized professional coding certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Professional Coder (CPC); or Certified Coding Specialist Physician (CCS-P).
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Institutional (Facility) Coding Certifications: ONE of the following recognized institutional coding certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Outpatient Coder (COC), or Certified Coding Specialist (CCS). Other institutional coding certifications will be considered by the MHS-MCPB on a case-by-case basis.
KNOWLEDGE SKILLS & ABILITIES :
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Excellent computer/communication skills for provider and staff interactions.
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Knowledge of anatomy/physiology and disease process, medical terminology, coding guidelines (outpatient), documentation requirements, familiarity with medications and reimbursement guidelines; and encoder experience.
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The ability to handle multiple projects and appropriately prioritize tasks to meet deadlines.
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Advanced knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT), as used in institutional and professional services medical coding.
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Advanced knowledge of reimbursement systems, including Prospective Payment System (PPS); Ambulatory Payment Classifications (APCs); and Resource-Based Relative Value Scale (RBRVS).
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Advanced knowledge and understanding of industry nomenclature; medical and procedural terminology; anatomy and physiology; pharmacology; and disease processes.
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Practical knowledge of medical specialties; medical diagnostic and therapeutic procedures; ancillary services (includes, but is not limited to: Laboratory, Dental, Occupational Therapy, Physical Therapy, and Radiology);and revenue cycle management concepts related to medical coding.
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Practical knowledge and 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. Includes, but not limited to: The Federal Register, Center for Medicare, and Medicaid Services (CMS) Local Coverage Determinations and National Coverage Determinations (LCD and NCD), National Correct Coding Initiative (NCCI) guidance, manual, and edits, Internet-Only Manuals (IOMs), and HHSOIG publications and reports.
DESIRED:
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Experience within MHS GENESIS and other military coding systems to complete encounters.
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Practical knowledge of clinical documentation improvement and continuous process improvement processes.
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Providing leadership and direction to the coding team, ensuring efficient and effective daily operations.
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Experience providing regular team meetings to communicate updates, address concerns, and foster a collaborative work environment.
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Conduct regular audits to ensure coding accuracy and compliance and other regulatory guidelines.
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Develop and implement training programs to ensure staff competency in medical coding.
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content-management-system Cost Per Thousand (CPT) icd apc data-management