Certified outpatient medical coder -- Fully remote (23348)

Responsibilities

Accurately assigns diagnosis, procedure, and supply codes for the professional and institutional (facility) components of Outpatient encounters IAW DHA and AFMS MCPO completeness, productivity, and timeliness standards. Also, provides or contributes to periodic reports IAW DHA and AFMS MCPO instructions and timelines 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 Maintains technical currency through continuing education and training opportunities Reviews encounter and/or record documentation to identify inconsistencies, ambiguities, or discrepancies that may cause inaccurate coding, medico-legal repercussions or impacts quality patient care. Identifies any problems with legibility, abbreviations, etc., and brings to the provider’s 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. Develops and submits a written (electronic or hard copy) query IAW DHA or AFMS MCPO guidelines to the provider to request clarification of provider documentation that is conflicting, ambiguous, or incomplete in regards to any significant reportable condition or procedure. Monitors query submission, response times, and completion. 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 DHA or AFMS MCPO guidance Acts as a source of reference to medical staff having 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. 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 Supports DHA and AFMS 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 Service coding representatives. May perform focused audits of specific MTFs, medical specialties, clinics, coders, or providers as directed and IAW DHA and/or AFMS audit procedures. 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 DHA and/or AFMS coding compliance requirements regarding training and reporting of potential violations. May assist with MTF initial and annual coding compliance training and tracking MTF coding compliance training The entry and transmittal of patient and coding data through different Government computer systems will sometimes be flagged for errors (known as “write-back errors”). Write-back errors are corrected by the MTF staff or coders and tracked through corrective action. Write-back errors generated by a patient administration error (for example, incorrect or missing demographic information) is corrected by the MTF Patient Administration section. The medical coder may be used to correct all write-back errors caused by coding errors Upon DHA or AFMS MCPO direction, utilizes MHS computer systems to remotely access patient records and assign codes for patient encounters in support of other MTFs Perform, limited focused audits of MTFs, specialties, clinics, or providers conducted, or Quality Assurance (QA) or peer reviews, IAW DHA requirements. If DHA requirements are not available at the time of award of this contract, all focused audits, QA, or peer reviews will be conducted IAW AFMS MCPO instructions Coding validation notifications (a.k.a. “CAPER” validations) are reports of certain diagnosis codes which may need further investigation and provider clarification. These areas may include smallpox, anthrax, abortions, flu, hepatitis, TB and others as designated as a Congressional, DHA, or AFMS MCPO reporting requirement. The coder will review coding validation notifications from the AFMS MCPO and ensure that identified codes are correct, making corrections when necessary. Encounters should be corrected within three business days and providers receive training on the consequences of the use of the codes assigned Provides or contributes to periodic reports IAW DHA and AFMS MCPO instructions and timelines May provide limited assistance as necessary to the MTF Data Quality, Group Practice Managers, or other MTF business functions in compiling, analyzing, and reporting MTF coding data for performance purposes QUALIFICATIONS: MSS personnel in this position are required to possess a current coding certification in good standing from EACH of the following categories: Professional Services Coding Certifications: The following are recognized professional certifications: Certified Professional Coder (CPC) or Certified Coding Specialist – Physician (CCS-P) Evaluation and Management (E&M) Auditor Certification: National Alliance of Medical Auditing Specialists (NAMAS) Certified Evaluation and Management Auditor (CEMA) Coding Test - employees must achieve a minimum 70% passing score and the candidate’s score must be reported in the qualification documents by the Contractor. An incumbent employee who has previously passed a test approved by the AFMS MCPO may be exempted from this requirement Minimum of three (3) years of medical coding and/or auditing experience in two (2) or more medical, surgical, and ancillary specialties within the past 10 years Minimum of one (1) year of performance in the specialty is required Practical knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT) Practical knowledge of reimbursement systems, including, but not limited to, Ambulatory Payment Classifications (APCs); and Resource-Based Relative Value Scale (RBRVS) Practical knowledge and 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, and Radiology); and revenue cycle management POSITION TIMING: Immediate hire upon Contract Award and completion of all background and security investigations. Candidates must be willing to sign a Letter of Intent for submission with their resume. SPECIAL NOTE: This position is contingent on the candidate’s ability to meet the physical and medical requirements specific to the role, including compliance with all applicable federal, state, and local regulations. Government or customer site-specific requirements may include, but are not limited to, providing proof of full COVID-19 vaccination status, unless the candidate is legally entitled to an exemption.

Benefits

Health, Dental, and Vision insurance 401(k) Retirement Plan Vacation Sick Leave Competitive salary based on experience and technical qualifications Disability & Life Insurance 11 Paid Federal Holidays including: New Year’s Day Martin Luther King, Jr. Day Presidents Birthday Memorial Day Juneteenth Independence Day Labor Day Columbus Day Veterans Day Thanksgiving Day Christmas Day EQUAL OPPORTUNITY EMPLOYER: Laredo Technical Services, Inc. (LTSI) is an Equal Opportunity/Affirmative Action Employer. We provide equal consideration to all qualified applicants regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. Please visit the link below for the "Know Your Rights" and "Pay Transparency Nondiscrimination" supplement posters: https://www.dol.gov/agencies/ofccp/posters LTSI is committed to ensuring an accessible online application process for all individuals, including those with disabilities. We offer alternative application methods for candidates who are unable to complete the online application due to a disability or other need for accommodation. LTSI complies with the Americans with Disabilities Act (ADA), Section 503 of the Rehabilitation Act of 1973, the Vietnam-Era Veterans’ Readjustment Assistance Act of 1974, and other relevant state and local laws. If you need assistance due to a disability, please contact our Recruiting Department at hr@laredotechnical.com or call (210) 425-5650. Qualifications