Job Description

Job Description

Job Description

SUMMARY: This position will support coding operations and compliance as part of the Modernization Study Program. The coding professional will conduct internal audits; monitor coding practices and documentation deficiencies to identify, develop, deliver training and monitor effectiveness of efforts to ensure improvement to documentation, coding completion, timeliness and accuracy rates for the MTF.

QUALIFICATIONS:

• Knowledge of The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-CM), procedural coding, healthcare common procedure coding system (HCPCS)/current procedural terminology (CPT) nomenclature, medical and procedural terminology, anatomy and physiology, pharmacology, and disease processes to perform the duties described. 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).
• Knowledge of and the ability to interpret guidelines, rules and regulations developed by: Centers for Medicare & Medicaid Services (CMS), American Medical Association (AMA), American Heart Association (AHA) and other applicable Federal requirements so as to provide timely and accurate information relating to coding, billing and documentation.
• Excellent oral and written communication skills, interpersonal skills along with the confidence to present complex medical coding issues and educational instruction to a diverse audience. Must be comfortable in front of high ranking, professional staff and coding peers to training and respond to questions.
• Ability to write reports, business correspondence, and procedure manuals.
• Organizational, analytical, time management, statistical, and problem solving skills.
• Advanced knowledge of computers, keyboard skills, and various software programs including Microsoft (word processing, spreadsheet and database) as well as coding software programs.

EDUCATION/CERTIFICATION:

• A minimum of one of the following: An associate's degree in health information management OR a certificate in medical coding, OR at least 30 hours university/college credit that includes relevant coursework such as anatomy/physiology, medical terminology, health information management, and/or pharmacology.

CODING CERTIFICATION:

• One of the following coding certifications is required: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Professional Medical Auditor (CPMA); Certified Professional Coder (CPC); Certified Outpatient Coder,(COC); Certified Inpatient Coder (CIC); Certified Coding Specialist (CCS); or Certified Coding Specialist – Physician (CCS-P).
• Other coding certifications may be considered but will require Government acceptance in accordance with the Equivalency Determination Request process outlined in Section H.3.f.(3) of the main contract.
• Education in paragraph 1.2.1 must be from an accredited educational institution recognized by the American Health Information Management Association (AHIMA) and/or American Academy of Professional Coders (AAPC)

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