Medical Coding Modernization Specialist
This position will support coding operations and compliance as part of the Medical Modernization Program. The CDIS 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.
Mandatory Knowledge and Skills.
· Knowledge of The International Classification of Diseases, Tenth 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.
A Registered Health Information Technician (RHIT) or equivalent certification is required. Other coding certifications may be considered. CDIS will maintain the required continuing education hours and credentials as required by their national association certification.
Successful completion of academic requirements, at least at an associate's degree level from a health information management program is required.
Candidates will require a minimum of 10 years of medical coding experience in production coding environments within the past 10 years, in more than 4 medical and surgical specialties, involving assignment of ICD, E&M, CPT, and HCPCS codes. Coding, auditing and training for ancillary services such as physical, occupational therapy, speech, and nutritional medicine as well as home health, skilled nursing facilities, rehabilitation care and urgent care clinics are not qualifying.
A minimum of four years of auditing, training, and/or compliance functions within the last eight years is required in at least 4 medical and surgical specialties as stated above. BUT
Preferred Education and Experience: The education and experienced requirements outlined above are required; however, the following are preferred:
A Baccalaureate Degree in Nursing, a Graduate Diploma in Nursing, or an Associate Degree in Nursing, from an accredited agency such as the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE). Additional educational considerations include other health related fields such as health administration, social work, etc.
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or Certified Documentation Improvement Practitioner (CDIP) certification.
A minimum of five (5) years of clinical experience with acute inpatient care.
Must be able to satisfy the eligibility requirements for obtaining a government issued security clearance (US citizenship is required) and must have a physical and annual immunizations as well as TB testing and flu shots. May be required to pass a coding assessment and or a clinical documentation improvement assessment.
VEVRRA Federal Contractor
Equal Opportunity Employer of protected veterans