AMBULATORY MEDICAL CODING AUDITOR Job at Anthony & Associates, Inc. dba AAI
AMBULATORY MEDICAL CODING AUDITOR
Tripler Army Medical Center
(Remote Position)
AAI is actively recruiting an Ambulatory Medical Coding Auditor to support the Tripler Army Medical Center (TAMC), which operates one of the largest medical facilities in the Army, located in Honolulu, Hawaii, serving as a tertiary care hospital with 181 beds. TAMC’s mission is to ensure medical readiness for worldwide contingencies by providing quality, cost-effective health care for more than 187,000 DoD and VA beneficiaries. In addition, the TAMC commander oversees the Hawaii Multi-Service Market.
This project requires AAI’s Auditors to have thorough and expert knowledge of, and skill in applying, a comprehensive body of rules, procedures, and operations, such as Army ambulatory care medical records activities with a focus on Orthopedics, operations, and regulations; medical terminology, procedures, anatomy, physiology, and disease processes; ICD-(-CM diagnosis, CPT procedural evaluation & management, and HCPS (Health Care Financing Administration’s Common Procedure Coding System) coding techniques; and Ambulatory Data Module (ADM) computerized data entry and retrieval systems sufficient to: conduct a wide range of quality assurance studies; make recommendations to improve procedures for compiling and retrieving medical records information; identify specific clinical findings, support existing diagnoses, or substantiate listing additional diagnoses in the medical record; code complicated medical records that are difficult to classify, proficiency in Microsoft Office Suite of products, to include Excel, Word and PowerPoint; possess ability to gather and represent data graphically and make a variety of basic statistical computations and perform basic analysis; identify possible trends and patterns for preparing reports; organize information, data and images into a coherent training presentation, effective verbal and written communication skills to discuss internal audits and assist in training providers, clerical staff and coding trainees.
Responsibilities
The Ambulatory Medical Coding Auditor will support the auditing of medical documentation and codes for compliance with federal coding regulations and guidelines. This will include the assignment of ICD, Current Procedure Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS) codes, modifiers, and quantities as documented by the physician. The Ambulatory Medical Coding Auditor also trains and educates MTF staff on coding issues and plays a significant role in coding compliance activities. The Ambulatory Medical Coding Auditors must have the following:
- Knowledge of auditing concepts and principles.
- Advanced knowledge of medical coding and billing systems and regulatory requirements.
- Strong communication and interpersonal skills.
- Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation.
- Knowledge of current and developing issues and trends in medical coding procedure requirements.
- Detailed knowledge of medical coding systems, procedures, and documentation requirements.
- Ability to adapt and modify medical billing procedures, protocol, and data management systems to meet specific operating requirements.
- Computer literate, with knowledge of coding and auditing packages, mainframe, and office software applications.
Requirements
- Ambulatory Auditor Certifications. Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Professional Coder-Hospital (CPC-H), Certified Coder Specialist-Physician (CCS-P), and/or Certified Coder Specialist (CCS) is acceptable with a minimum of 5 years medical coding experience (encompassing multiple clinical specialties) and 3 years of medical auditing experience within the last eight years is required. The candidates possessing a Certified Professional Medical Auditor (CPMA) certification must have a minimum of 2 years of medical auditing experience within the last 5 years of medical coding experience (encompassing multiple clinical specialties).
- An accrediting institution recognized by the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC) must accredit education.
- The Ambulatory Medical Coding Auditor must have 2 years of Emergency Medicine coding experience within the past 10 years.
- CONTINUED EDUCATION REQUIREMENTS: Contract medical coders will obtain the required continuing education hours at no expense to the government in order to maintain the current and proper national certification(s) required for the position.
- Experience. A minimum of 5 years of medical coding experience in multiple clinical specialties and three years of medical auditing experience within the last eight years is required. Expertise must also include ambulatory surgery coding/auditing for the outpatient auditor reviewing APV encounters.
- Work Environment/Physical Requirements. The work is primarily sedentary. Requirements include prolonged walking, standing, sitting, or bending. Carrying or lifting medical records is usually required daily. Use of one or more computer programs and monitors may be required to efficiently accomplish duties.
UNIQUE MILITARY HEALTH CARE SYSTEMS/PROCEDURES:
- Armed Forces Health Longitudinal Technology Application (AHLTA).
- Composite Health Care systems (CHCS) and/or MHS GENESIS.
- Defense Enrollment Eligibility Reporting System (DEERS).
- Military Filing System - by sponsor social security number, terminal digit order, color-coded and blocked filing system.
- Contents of a military medical record, layout, sections, family member prefix designation, forms used in an MTF, and the medical record tracking procedures.
- EssentrisTM, the client-server version of the Clinical Information System (CIS).
- Coding Compliance Editor (CCE) Systems.
- Biometric Data Quality Assurance Service (BDQAS) - https://bdqas.afms.mil/index2.htm
- AFMS Internal Coding Audit Methodology - AFMOA Audit Tool/ Coding Audit Review System (CARS) or current audit tool.
- MHS Coding Guidelines http://www.tricare.mil/ocfo/bea/ubu/coding_guidelines.cfm
About AAI
AAI is focused on delivering outstanding services to the federal government. We have extensive experience in the fields of cyber security, development, IT infrastructure, supply chain management, and other professional services such as system design and continuous improvement. AAI is a VA CVE-certified Service-Disabled Veteran-Owned Small Business (SDVOSB), SBA-certified Economically Disadvantaged Woman Owned Small Business (EDWOSB), and a Woman Owned Small Business (WOSB) with offices in Hampton Roads Virginia, Montgomery, AL, Washington DC, and Atlanta. Our website is https://aaionline.us/.
Our benefits include:
- Paid Federal Holidays
- Robust Healthcare and Dental Insurance Options
- 401a plan
- 401k plan
- Paid vacation and sick leave
- Continuing education assistance
- Short Term / Long Term Disability & Life Insurance
Veterans are encouraged to apply
AAI does not discriminate in employment opportunities, terms and conditions of
employment, or practices on the basis of race, age, gender, religious or political beliefs,
national origin or heritage, disability, sexual orientation, or any characteristic protected
by law. Pending guidance from the Safer Federal Workforce, employees may in the
future be required to provide evidence of COVID-19 vaccination or request and receive
approval for a medical or religious exemption.
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