Overview: Responsibilities:

• Adheres to accepted coding practices, 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 opportunities.
• 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 provider’s attention.
• May perform assessments and examine records for proper sequence of documents, presence of authorized signatures, and sufficient data is documented that supports diagnosis, treatment administered, and results obtained.
• Develops and submits a written (electronic or hard copy) query IAW DHA guidelines to the provider to request clarification of provider documentation that is conflicting, ambiguous, or incomplete in regard to any significant reportable condition or procedure.
  
• Monitors query submission, response times, and completion. Educates and provides feedback to providers and clinical staff to resolve documentation issues to support coding compliance.
  
• Assigns accurate codes to encounters based upon provider responses to queries and reports queries and responses IAW DHA guidance.
  
• Acts as a source of reference to medical staff that have questions, issues, or concerns related to coding.
  
• Responds to provider questions and provides examples of appropriate coding and documentation reference(s) to provide clarity and understanding.
  
• Based on contacts from the medical staff, identifies training opportunities and works with coding training personnel to focus on consistency and clarity of coding advice provided.
  
• Collaborates with Medical Coding Trainers in developing, delivering, and monitoring initial and annual coding training to providers and clinical staff by providing guidance to professional and technical staff in documentation requirements for coding.
  
• Supports DHA coding compliance by performing due diligence in ethically and appropriately researching and/or interpreting existing guidance, including seeking clarification from the Lead Medical Coder, supervisor, or DHA-MCPB. Performs administrative related tasks associated with medical records final reviews/audits and contacting various departments, services, or medical staff to obtain data needed to complete the records. Complies with DHA coding compliance requirements regarding training and reporting of potential violations. May assist with MTF initial and annual coding compliance training and tracking MTF coding compliance training.
• Upon DHA or DHA-MCPB direction, utilizes MHS computer systems to access patient records and assign codes for patient encounters in support of other MTFs in the Indo-Pacific region.
  
• Performs limited focused audits of MTFs, specialties, clinics, or providers conducted, or Quality Assurance (QA) or peer reviews IAW DHA requirements.
• Provides or contributes to periodic reports IAW DHA MCPB instructions and timelines.
  
• May provide limited assistance as necessary to the MTF Data Quality, Group Practice Managers, or other MTF business functions in compiling, analyzing, and reporting MTF coding data for performance purposes.

Qualifications:

• An associate’ degree or higher in Health Information Management or Healthcare Administration or biological science; or
• A University certificate in medical coding; or
• At least 30 semester hours of University/College credit that includes relevant coursework such as anatomy/physiology, medical terminology, health information management, and/or pharmacology; or
• Successful completion of an American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) coding certification preparation course for professional services or facility coding that includes medical terminology, anatomy and physiology, health information management concepts, and pharmacology; or
• Successful completion of a training course beyond apprentice level for medical technicians, hospital corpsmen, medical service specialists, or hospital training, obtained in a training program given by the Armed Forces or the United States Maritime Service under close medical and professional supervision.

• Medical Coding personnel in this position are required to possess a minimum of five years of medical coding and/or auditing experience in two or more medical, surgical, and ancillary specialties within the past 10 years. A minimum of one year of performance in the specialty is required to be qualifying.
  
• Advanced knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Procedural Coding System (PCS); 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) and Diagnostic Related Groupings (DRGs); 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, Occupational Therapy, Physical Therapy, and Radiology), and revenue cycle management concepts.
  
• 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.

• Professional Services Coding Certifications. One of the following recognized professional coding certifications: RHIT, RHIA, Certified Professional Coder (CPC), or Certified Coding Specialist – Physician (CCS-P).
  
• Institutional (Facility) Coding Certifications. One of the following recognized institutional coding certifications: RHIT, RHIA, Certified Inpatient Coder (CIC), or Certified Coding Specialist (CCS). Other institutional coding certifications will be considered by the DHA-MCPB on a case-by-case basis.
Evaluation & Management (E&M) Coding or Auditing Certifications. One of the following recognized E&M coding certifications: Certified Evaluation & Management Coder (CEMC) from AAPC; or Certified Evaluation and Management Auditor (CEMA) from the National Alliance of Medical Auditing Specialists (NAMAS).

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AKAHI ASSOCIATES LLC
AKAHI Associates 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.
Akahi Associates 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.