[Hiring] Medical Records Technician (Coder) Auditor @Dayton VA Medical Center

Role Description

The Dayton Ohio VA Medical Center's Health Information Management Service is recruiting for a well-qualified Medical Records Technician - Coder Auditor.

• Reviews, analyzes and reports performance monitors for PTF, PCE, VERA and Non-VA Medical Care (purchased care) coding.
• Audit accurate and complete assignment of:
  • ICD-10-CM and ICD-10-PCS codes
  • MS-DRG, POA status, and discharge disposition values for inpatient health records
  • ICD-10-CM, CPT, and HCPCS codes for outpatient health records
• Audit function includes evaluation of clinical documentation to support optimal code assignment.
• Reviews coding and assists coders in improving coding accuracy; provides coding guidance to various levels of staff to promote consistency in practice and compliance with coding rules and regulations; initiates various reports and analyzes data.
• Facilitates improved overall quality, completeness and accuracy of coded data.
• Ensures the accuracy and completeness of clinical information used for measuring and reporting physician and medical center outcomes with continuing education to all members of the patient care team on an ongoing basis.
• Responsible for performing audits of coded data, developing criteria, collecting data, graphing and analyzing results, creating reports and communicating in writing and/or in person to appropriate leadership and groups.
• Collaboratively works with coding staff and clinical staff to provide support and education on coding issues.
• Provides training and education to coding and clinical staff.
• Researches complex coding issues and participates in process improvements related to coding.
• Assists in the development of guidelines for data quality, consistency, and monitoring for compliance to improve the quality for clinical, financial, and administrative data.
• Ensures that all coded data is fully documented and supported to prevent billing denials and fraud.
• As a technical expert in health information coding matters, provides advice and guidance on documentation and coding requirements.
• Maintains current knowledge to ensure that coding and documentation meets regulatory guidelines and audit standards.
• Analyzes audit results and prepares summary feedback for individual coders and/or clinicians, making recommendations for improvement.
• Provides coding consultation to coders and/or clinicians related to coding and documentation questions.
• Maintains statistical databases to track results and validate the program for identifying patterns and variations in coding practices.

Qualifications

• United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
• Experience and Education:
  • One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of health records.
  • An associate's degree from an accredited college or university recognized by the U.S. Department of Education with a major in health information technology/health information management, or related degree with a minimum of 12 semester hours in health information technology/health information management.
  • Completion of an AHIMA approved coding program, or other intense coding training program of approximately one year or more.
  • Equivalent combinations of creditable experience and education are qualifying for meeting the basic requirements.
• Certification:
  • Apprentice/Associate Level Certification through AHIMA or AAPC.
  • Mastery Level Certification through AHIMA or AAPC.
  • Clinical Documentation Improvement Certification through AHIMA or ACDIS.
• Loss of Credential: Credentials must be maintained through rigorous continuing education.
• Grandfathering Provision: All persons employed in VHA as a MRT (Coder) on the effective date of this qualification standard are considered to have met all qualification requirements.

Requirements

• One year of creditable experience equivalent to the journey grade level of a MRT (Coder).
• Employees at this level must have a mastery level certification.
• Demonstrated Knowledge, Skills, and Abilities:
  • Advanced knowledge of current coding classification systems such as ICD, CPT, and HCPCS.
  • Ability to research and solve complex questions related to coding conventions and guidelines.
  • Ability to review coded data and supporting documentation for adherence to standards.
  • Ability to format and present audit results, identify trends, and provide guidance.
  • Skill in interpersonal relations and conflict resolution.

Benefits

• Competitive salary and regular salary increases.
• 37-50 days of annual paid time off per year (13-26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays).
• Parental Leave: Up to 12 weeks of paid parental leave after 12 months of employment.
• Child Care Subsidy: Eligible for a childcare subsidy up to 25% of total eligible childcare costs after 60 days of employment.
• Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% contributions by VA.
• Insurance: Federal health/vision/dental/term life/long-term care insurance options.

Company Description

The full performance level of this vacancy is GS8. The actual grade at which an applicant may be selected for this vacancy is GS9.