|Required Experience:||3 to 4 years
|Preferred Experience:||1 to 2 years
SUMMARY: Responsible for assignment of accurate Evaluation and Management (E&M) codes, ICD-9 diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic) for outpatient encounters. Trains and educates MTF staff on coding issues and plays a significant role in coding compliance activities.
1.1 Mandatory knowledge and skills.
1.1.1 Position requires excellent computer/communication skills for provider and staff interactions.
1.1.2 Knowledge of anatomy/physiology and disease process, medical terminology, coding guidelines (outpatient), documentation requirements, familiarity with medications and reimbursement guidelines; and encoder experience.
1.1.3 Candidate must have ability to handle multiple projects and appropriately prioritize tasks to meet deadlines.
1.2 Education/Certification. The following are recognized certifications:
1.2.1 Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC) CCS-P (Certified Coder Specialist -- Physician (CCS-P) with the appropriate level of experience.
1.2.2 An accrediting institution recognized by the American Health Information Management Association (AHIMA) and/or American Academy of Professional Coders (AAPC) must accredit education.
184.108.40.206 Continued Education Requirements: Contract medical coders will obtain the required continued education hours at no expense to the government in order to maintain current and proper national certification(s) required for the position.
1.3 Experience. A minimum of three year experience in the outpatient setting (physician's office or ambulatory surgery centers) within the last five years, including assignment of E&M, CPT, and HCPCS codes. Multiple specialties encompass different medical specialties (i.e. Family Practice, Pediatrics, Gastroenterology, OB/GYN, etc.) that utilize ICD, E&M, CPT, and HCPCS codes. Ancillary specialties (PT/OT, Radiology, Lab, Nutrition, etc.) that usually do NOT use E&M codes do not count as qualifying experience. Additionally, coding, auditing and training exclusively for specialties such as home health, skilled nursing facilities, and rehabilitation care will not be considered as qualifying experience. Coding experience limited to making codes conform to specific payer requirements for the business office (insurance billing, accounts receivable) is not a qualifying factor.. Two years of outpatient/ambulatory surgery experience may be qualifying if received in a military medical facility.
1.4 Work Environment/Physical Requirements. The work is primarily sedentary. Requirements may include prolonged walking, standing, sitting or bending. Carrying or lifting of medical records may be required daily. Use of one or more computer programs and monitors may be required daily.
2 UNIQUE MILITARY HEALTH CARE SYSTEMS/PROCEDURES:
2.1 Armed Forces Health Longitudinal Technology Application (AHLTA)
2.2 Composite Health Care systems (CHCS)
2.3 Defense Enrollment Eligibility Reporting System (DEERS);
2.4 Military Filing System - by sponsor social security number, terminal digit order, color-coded and blocked filing system.
2.5 Contents of a military medical record, layout, sections, family member prefix designation, forms used in a MTF, and the medical record tracking procedures.
2.6 EssentrisTM, the client-server version of the Clinical Information System (CIS)
2.7 Coding Compliance Editor (CCE) Systems
2.8 Biometric Data Quality Assurance Service (BDQAS) - https://bdqas.afms.mil/index2.htm
2.9 AFMS Internal Coding Audit Methodology - AFMOA Audit Tool
2.10 MHS Coding Guidelines http://www.tricare.mil/ocfo/bea/ubu/coding_guidelines.cfm
3 PERFORMANCE OUTCOMES:
3.1 Responsible for assignment of accurate E&M, ICD-9, CPT and HCPCS codes and modifiers from medical record documentation.
3.2 Identifies and abstracts information from medical records (paper or electronic) for special studies and audits, internal and external.
3.3 Interacts with MTF staff to ensure documentation is clear and supports coding assignments. Educates MTF staff through individual or group in-services and training sessions.
Maintains a delinquency report of missing records in order to facilitate completion of work within the required Air Force thresholds.