Role Description
We are seeking experienced Medical Coders / HIMS Coding Specialists to provide medical coding, coding validation, auditing, and clinical documentation review services supporting Veterans Health Administration (VHA) VISN 7 facilities. The selected candidate will be responsible for accurately reviewing medical records and assigning appropriate diagnosis and procedure codes for inpatient, outpatient, professional fee, surgical, and specialty healthcare services.
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Perform accurate medical coding for inpatient and outpatient healthcare encounters.
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Review medical records and assign appropriate ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II codes.
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Perform coding validation and quality audits to ensure coding accuracy and completeness.
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Review clinical documentation and identify documentation deficiencies and coding discrepancies.
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Support Clinical Documentation Improvement (CDI) activities.
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Identify potential coding, reimbursement, compliance, and documentation risks.
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Review coding information within systems such as VistA, PCE, PTF, Integrated Billing (IB), and related healthcare applications.
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Perform professional fee, surgery, specialty, and other applicable medical coding.
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Ensure all assigned encounters are coded accurately, including non-billable encounters.
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Maintain compliance with VA/VHA policies, Federal regulations, and nationally recognized coding guidelines.
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Participate in coding education and provide feedback regarding documentation and coding quality.
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Prepare coding audit reports and quality assurance documentation.
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Maintain confidentiality and security of Veteran health information.
Qualifications
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Experience in medical coding, HIMS, coding auditing, or healthcare revenue cycle.
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Strong knowledge of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II.
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Experience with inpatient and/or outpatient medical coding.
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Knowledge of medical terminology, anatomy, physiology, and clinical documentation.
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Experience performing coding audits and validation reviews.
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Strong understanding of healthcare coding compliance and documentation requirements.
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Ability to work independently in a remote environment.
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Strong attention to detail and analytical skills.
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Excellent written and verbal communication skills.
Requirements
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Experience supporting VA/VHA, Veterans Health Administration, or Federal healthcare facilities.
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Experience with VistA, PCE, PTF, Integrated Billing (IB), or similar healthcare information systems.
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Experience with Clinical Documentation Improvement (CDI).
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Experience in coding quality assurance and auditing.
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CPC, CCS, CCS-P, CCA, or other recognized coding certification preferred.
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Experience with inpatient, outpatient, professional fee, surgery, and specialty coding.
Core Skills
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Medical Coding
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HIMS
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ICD-10-CM
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ICD-10-PCS
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CPT
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HCPCS
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Medical Auditing
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Coding Validation
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Clinical Documentation Review
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CDI
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VistA
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PCE
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PTF
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Integrated Billing
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Healthcare Compliance
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Quality Assurance
Work Environment
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100% Remote
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Work will be performed remotely and not at the contractor's physical facility.
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Candidate must be able to meet all applicable security, confidentiality, and Federal healthcare requirements.
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This is a remote position.