Medical Coder - Ambulatory

Location: Remote to support Defense Health Network Pacific Rim

Position Title: Medical Coder II - Ambulatory (Ambulatory Procedure Visit)

Pay rate: $31/hr + Health & Wellness $4.57*/hr worked (in lieu of benefits)

Work Schedule: The Contractor is expected to maintain a schedule for this contract of eight (8) hours daily Monday through Friday for production coding operations not to exceed forty (40) hours per work week.

Benefits: Vested vacation, sick leave, holiday leave, Life, Accidental Death and Dismemberment, Short Term Disability

Optional Benefits: Medical, Dental, Vision, 401(K) matching with employee participation in 401(K) plan

• The DHN Pacific Rim provides authority, direction, and control over nine (9) military medical treatment facilities (MTFs) and supports functions such as medical coding.  
• DHA medical treatment facilities migrated to a new electronic health record (EHR), MHS GENESIS. All DHA MTFs have now migrated to the new system. MHS GENESIS^® exponentially increases coding workload as now all inpatient and ambulatory encounters include professional services and technical (facility) coding requirements. Some of the technical coding may be auto-coded (i.e., hard-coded) by the system, but may require review and modification by coders depending upon the clinical documentation and coding rules. 

• Accurately assigns diagnosis and procedure codes for facility and professional services for Day Surgery (a.k.a. Ambulatory Procedure Visit (APV)), Dental surgical procedures, Observation, Emergency Department (ED), outpatient ERSA, outpatient procedures, outpatient specialty encounters, and any outpatient primary care encounters billable to a third party IAW DHA accuracy, completeness, productivity, and timeliness standards. Work may involve areas such as Laboratory, Radiology, and Dental services. Codes records with correct Ambulatory Payment Classifications (APCs); and Relative Value Units (RVUs) in order for the Center to receive correct reimbursement or workload credit. Performs necessary tasks within MHS GENESIS® and other military coding systems (to include, but not limited to, 3M Encompass 360, Joint Legacy Viewer (JLV)) to complete encounters. Researches and resolves coding edit failures as assigned.
• Adheres to accepted coding DHA and industry guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or E&M 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 courses, webinars, and other learning opportunities IAW AAPC and AHIMA CEU requirements for maintaining the coding certifications required for the position.
• Reviews encounter and/or record documentation to identify inconsistencies, ambiguities, or discrepancies that may cause inaccurate coding, medico-legal re-percussions or impacts quality patient care.  Identifies any problems with legibility, abbreviations, etc., and brings it to the medical provider’s attention.
• When necessary, develops and submits a written (electronic or hard copy) query IAW DHA Coding Compliance Plan to the provider to request clarification of provider documentation that is conflicting, ambiguous, or incomplete regarding any significant reportable condition or procedure. Monitors query submission, response times, and completion. Assigns accurate codes to encounters based upon provider responses to queries and reports queries and responses IAW DHA Coding Compliance Plan. 
• Supports DHA coding compliance by performing due diligence in ethically and appropriately researching and/or interpreting existing guidance, including seeking clarification from the contractor supervisor or DHN Pacific Rim.
• Reviews and resolves coding edit failures in MHS GENESIS^®.

• Experience: Coding personnel in this position are required to possess a minimum of four (4) years of medical coding and/or auditing experience in two (2) or more medical, surgical, and ancillary specialties within the past 10 years; OR a minimum of two (2) years of medical coding or auditing experience if that experience was in an MTF. A minimum of one (1) year of performance in the specialty is required to be documented to be considered qualifying.
• Certification: Registered Health Information Technologist (RHIT) or Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Coder Specialist (CCS), Certified Coder Specialist – Physician (CCS-P) are preferred for outpatient/ambulatory surgery medical coders as long as candidate has a minimum of three year experience in the outpatient setting (physician’s office or ambulatory care centers) within the last five years.
  
• Education: An institution recognized by the American Health Information Management Association (AHIMA) and/or American Academy of Professional Coders (AAPC) must accredit education. A 

• Medical Coding Test. Contract personnel must achieve a minimum 80% passing score

• Advanced knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT), as used in institutional and professional services medical coding.
• Advanced knowledge of reimbursement systems, including Prospective Payment System (PPS); Ambulatory Payment Classifications (APCs); and Resource-Based Relative Value Scale (RBRVS).
• Advanced 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, Dental, Occupational Therapy, Physical Therapy, and Radiology); and revenue cycle management concepts related to medical coding.
• Practical knowledge and understanding of Government rules and regulations regarding medical coding, reimbursement guidelines, and healthcare fraud; commercial reimbursement guidelines and policies; coding audit principles and concepts, and potential areas of risk for fraud and abuse. Includes, but not limited to: The Federal Register, Center for Medicare, and Medicaid Services (CMS) Local Coverage Determinations and National Coverage Determinations (LCD and NCD), National Correct Coding Initiative (NCCI) guidance, manual, and edits, Internet-Only Manuals (IOMs), and HHS-OIG publications and reports.
•  Practical knowledge of clinical documentation improvement and continuous process improvement processes.
•  Practical knowledge of EHR systems and workflows pertaining to medical coding.

KAKO'O Services LLC

Kako'o Services is a premier provider of healthcare workers to various military treatment facilities across the United States. With a corporate office in Honolulu, Hawaii and recruiting office in San Antonio, Texas we specialize in providing skilled, trained and highly successful healthcare workers, including RNs, CRNAs, Physicians, LPN/LVN, Licensed Social Workers, and many more.

We have a strong focus on providing our government customers with quality and superior service.

Kako'o Services is an equal opportunity employer and Minorities, Females, Veterans, and Disabled persons are encouraged to apply. For further information, please click the link below to view the EEO Is The Law poster.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.

Only qualified individuals who are being considered will be contacted for an interview.