SUMMARY:Medical coding compliance consists of providing analysis, auditing, investigation, recommendations, research, and other support to ensure observance or conformity with official coding policies, regulations, requirements, and standards. Revenue integrity consists of providing analysis, auditing, investigation,recommendations, research, and other support to prevent or recapture lost revenue from healthcare operations.
1. Advanced knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM), and Procedural Coding System (PCS); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT).
2. 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).
3. Advanced knowledge and understanding of industry nomenclature; medical and procedural terminology; anatomy and physiology; pharmacology; and disease processes.
4. 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.).
5. Thorough 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.
6. Advanced knowledge of revenue cycle management, project management concepts, business analysis, training methods, clinical documentation improvement, and continuous process improvement processes.
Education: A minimum of one of the following:
1. An associate's degree in Health Information Management;
2. A university certificate in medical coding.
Medical Coding Compliance Specialist are required to possess a Coding certification in good standing from each of the following:
- Professional Services Coding Certifications: The following are recognized professional certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Professional Medical Coding Auditor (CPMA); Certified Professional Coder (CPC); Certified Outpatient Coder (COC); or Certified Coding Specialist - Physician (CCS-P).
- Institutional (Facility) Coding Certifications: Certified Inpatient Coder (CIC), Certified Coding Specialist (CCS). Other institutional coding certifications will be considered by the AFMS MCPO on a case-by-case basis.
- Compliance Certifications:** Certified Professional Compliance Officer (CPCO) from AAPC; Certified in Healthcare Compliance (CHC) or Certified Compliance and Ethics Professional (CCEP) from the Healthcare Compliance Association (HCCA). Other compliance certifications will be considered by the AFMS MCPO on a case-by-case basis.
- Continuing Education Requirements: Medical coders shall maintain the required continuing education hours in order to maintain current and proper national certification(s) requirements for this position at no expense to the Government
A minimum of three years' training experience within the last six years in a military coding environment. A minimum of one (1) year of performance in the specialty is required to be qualifying. Training expertise must include identifying coding training opportunities; developing training plans and material, and instruction/delivery of the training to medical coder and clinical audiences.
MindLeaf Technologies Inc is an Equal Opportunity Employer and does not discriminate against candidates or employees based on race, color, religion, sex, national origin, age, pregnancy, disability, veteran status, genetic history, or any other protected status.
Job Location: Elmendorf AFB, AK - Anchorage, AK
Position Type: Full Time
Education Level: 2 Year Degree
Salary Range: $30.00 - $32.00 Hourly
Travel Percentage: None
Job Shift: Day
Job Category: Health Care