Medical Records Technician (Coder) Auditor (Outpatient & Inpatient)

Full-Time
Wichita, KS
US Department Of Veterans Affairs
Posted 3 years ago – Accepting applications

Job Description

Duties

Summary

The Wichita VA Medical Center is recruiting for Medical Records Technician (Coder) Auditor to work in the largest city in the state of Kansas. The Wichita metro population is roughly 500,000 and has a charming area with relatively reasonable cost for housing, 28 art galleries, 33 museums, and award-winning cultural opportunities. We are proudly home to the Wichita State Shockers Men's College Basketball team. Live and work in the heart of America!

Responsibilities

The following are examples of the duties for a Medical Record Technician (Coder) Auditor (Outpatient & Inpatient). The duties performed are NOT limited to the ones listed.

Reviews, analyzes and reports performance monitors for PTF, PCE, VERA and Non-VA Medical Care (purchased care) coding.
Audit accurate and complete assignment of ICD-10-CM and ICD-10-PCS codes, MS-DRG, POA status, and discharge disposition values for inpatient health records. Audit accurate and complete assignment of ICD-10-CM, CPT, and HCPCS codes, including appropriate E/M assignment and modifier usage for outpatient health records. Audit function includes evaluation of clinical documentation to support optimal code assignment.
Reviews coding and assist coders in improving coding accuracy; provides coding guidance to various levels of staff to promote consistency in practice and compliance with coding rules and regulations; initiates various reports and analyze data.
Facilitates improved overall quality, completeness and accuracy of coded data. Ensures the accuracy and completeness of clinical information used for measuring and reporting physician and medical center outcomes with continuing education to all members of the patient care team on an ongoing basis.
Responsible for performing audits of coded data, developing criteria, collecting data, graphing and analyzing results, creating reports and communicating in writing and/or in person to appropriate leadership and groups.
Collaboratively works with coding staff and clinical staff to provide support and education on coding issues. Provides training and education to coding and clinical staff. Researches complex coding issues and participates in process improvements related to coding.
Assists in the development of guidelines for data quality, consistency, and monitoring for compliance to improve the quality for clinical, financial, and administrative data to ensure that all coded data is fully documented and supported. Such efforts are conducted to ensure the accuracy of billing denials and prevention against fraud and abuse and to optimize the medical center's authorized reimbursement for utilization of resources provided.
As a technical expert in health information coding matters, provides advice and guidance on documentation and coding requirements. Maintains current knowledge to ensure that coding and documentation meets regulatory guidelines and audit standards, and results in appropriate data capture and reimbursement.
Analyze audit results and prepare summary feedback for individual coders and/or clinicians, making recommendations for improvement. Provide coding consultation to coders and/or clinicians related to coding and documentation questions.
Maintains statistical database(s) to track the results and validate the program for identifying patterns and variations in coding practices with regular reports to the medical staff and management.

Work Schedule:

Financial Disclosure Report:

Bargaining Unit:

Salary Range:

Functional Statement Title/#:

Telework or Virtual Assignment MAY be eligible for a highly qualified applicant.

Travel Required

Occasional travel - You may be expected to travel for this position.

Supervisory status

Promotion Potential

None

Job family (Series)
0675 Medical Records Technician
Similar jobs
- Coders, Health Information
- Health Information Coders
- Health Information Technicians
- Medical Records And Health Information Technicians
- Medical Records Specialists
- Medical Records Technicians
Requirements
RequirementsConditions of Employment
- You must be a U.S. Citizen to apply for this job
- Designated and/or random drug testing may be required
- Selective Service Registration is required for males born after 12/31/1959
- You may be required to serve a probationary period
- Subject to a background/security investigation
- Must be proficient in written and spoken English
- Selected applicants will be required to complete an online onboarding process
QualificationsBasic Requirements:

U.S. citizenship. Non-citizens may be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.

English Language Proficiency. Medical Records Technicians (Coders) must be proficient in spoken and written English as required by 38 U.S.C. 7403(f).

Experience or Education
Experience. One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of health records;
OR,
Education.
An associate's degree from an accredited college or university recognized by the U.S. Department of Education with a major field of study in health information technology/health information management, or a related degree with a minimum of 12 semester hours in health information technology/health information management (e.g., courses in medical terminology, anatomy and physiology, medical coding, and introduction to health records)Combination of Experience and Education. Equivalent combination of experience and education are qualifying for entry level for which both education and experience are acceptable,
OR,
Completed an AHIMA approved coding program, or other intense coding training program of approximately one year or more that included courses in anatomy and physiology, medical terminology, basic ICD diagnostic/procedural, and basic CPT coding. The training program must have led to eligibility for coding certification/certification examination, and the sponsoring academic institution must have been accredited by a national U.S. Department of Education accreditor, or comparable internal accrediting authority at the time the program was completed;
OR,
Experience/Education Combination.
I have an equivalent combination of creditable experience and education to meet the basic requirements. The following educational/training substitutions are appropriate for combining education and creditable experience:
- Six months of creditable experience that indicates knowledge of medical terminology, general understanding of medical coding and the health record, and one year above high school, with a minimum of 6 semester hours of health information technology courses.
- Successful completion of a course for medical technicians, hospital corpsmen, medical service specialists, or hospital training obtained in a training program given by the Armed Forces or the U.S. Maritime Service, under close medical and professional supervision, may be substituted on a month-for month basis for up to six months of experience provided the training program included courses in anatomy, physiology, and health record techniques and procedures. Also, requires six additional months of creditable experience that is paid or non-paid employment equivalent to a MRT (Coder).
AND,

Certification: As part of the basic requirements for this occupation, persons hired or reassigned to Medical Records Technician (Coder) position in the GS-0675 series in VHA must have either (1), (2), or (3) below:
(1) Apprentice/Associate Level Certification through AHIMA or AAPC.
(2) Mastery Level Certification through AHIMA or AAPC.
(3) Clinical Documentation Improvement Certification through AHIMA or ACDIS.

(The Medical Records Technician (Coder) Auditor is an assignment above the journey level; therefore, you must have a mastery level certification through AHIMA or AAPC to qualify for this position, mentioned below).

Grade Determination

GS-9 MRT (Coder) Auditor (Outpatient & Inpatient)

Experience or Education.
You must have 1 year of creditable experience equivalent to the journey grade level of a Medical Records Technician (Coder). This experience can include but is not limited to, performing the full scope of inpatient and outpatient coding duties; selecting and assigning codes from current versions of ICD CM, PCS, CPT, and HCPCS classification systems to both inpatient and outpatient records; independently reviewing and abstracting clinical data from the record for documentation of diagnoses and procedures to ensure it is adequate and appropriate to support the assigned codes; coding all complicated and complex medical/specialty disease processes, patient injuries, and all medical procedures in a wide range of ambulatory/inpatient settings and specialties; directly consult with clinical staff for clarification of conflicting, incomplete, or ambiguous clinical data in the health record; abstracting, assigning, and sequencing codes into encoder software; review provider health record documentation to ensure it supports diagnostic procedural codes assigned and is consistent with required medical coding nomenclature.

In addition, candidates MUST demonstrate the following Knowledge, Skills, & Abilities (KSAs):
- Advanced knowledge of current coding classification systems such as ICD, CPT, and HCPCS for the subspecialty being assigned (outpatient and inpatient).
- Ability to research and solve complex questions related to coding conventions and guidelines in an accurate and timely manner.
- Ability to review coded data and supporting documentation to identify adherence to applicable standards, coding conventions and guidelines, and documentation requirements.
- Ability to format and present audit results, identify trends, and provide guidance to improve accuracy.
- Skill in interpersonal relations and conflict resolution to deal with individuals at all organizational levels.
Certification. The Medical Records Technician (Coder) Auditor is an assignment above the journey level; therefore, you must have a mastery level certification through AHIMA or AAPC to qualify for this position.
- Current mastery level certifications include: Certified Coding Specialist (CCS), Certified Coding Specialist - Physician-based (CCS-P), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC).
Assignment.
Auditors must be able to perform all duties of a MRT (Coder). Auditors serve as experts of current coding conventions and guidelines related to professional and facility coding. Auditors perform audits of encounters to identify areas of non-compliance in coding. They facilitate improved overall qualify, completeness, and accuracy of coded data. They provide recommendations on appropriate coding and are responsible for maintain current knowledge of the various regulatory guidelines and requirements. They assist facility staff with documentation requirements to completely and accurately reflect the patient care provided. They provide technical support in the areas of regulations and policy, coding requirements, resident supervision, reimbursement, workload, accepted nomenclature, and proper sequencing. They directly consult with clinical staff for clarification of conflicting or ambiguous clinical data. They use computer applications with varied functions to produce a wide range of reports, to abstract records, and review assigned codes. They perform prospective and retrospective coding audits and use results to identify documentation, coding inadequacies, and re-educate clinical and coding staff based on audit results. They act independently to plan, organize, and perform auditing with emphasis on data validation, analysis, and generation of reports. They assist in the development of guidelines for data quality, consistency, and monitoring for compliance to improve the quality of clinical, financial, and administrative data. They ensure all coded data is fully documented and supported.

References: VA Handbook 5005/122, Part II, Appendix G57

Physical Requirements: Most of the work is sedentary and involves data entry into a computer. Must be able to communicate with the veteran patient, their family, and staff. May involve carrying light loads such as paper files. Education
IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.
Additional information
Receiving Service Credit or Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. VA may offer newly-appointed Federal employee's credit for their job-related non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed.

This job opportunity announcement may be used to fill additional vacancies.

It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.

This position is in the Excepted Service and does not confer competitive status.

VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority.

Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members.

If you are unable to apply online view the following link for information regarding an Alternate Application.

How You Will Be Evaluated
You will be evaluated for this job based on how well you meet the qualifications above.
IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Your application, résumé, C.V., and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment.

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.
Background checks and security clearanceSecurity clearance
Other
Drug test required
No
Position sensitivity and risk
Non-sensitive (NS)/Low Risk
Trust determination process
Suitability/Fitness
Required Documents
Required Documents
To apply for this position, you must provide a complete Application Package which includes:
- Professional Certification
- Resume
To apply for this position, you must provide a complete application package. Requests for reconsideration of ratings will not be considered for applicants who fail to submit required documents. We cannot be held responsible for incompatible software or uploads. Required documents are listed below.

The following documents are required:
- Resume (required) - Resume must include the following information for each job listed: job title, duties, start and end dates, full time or part time status (include hours worked per week). Be sure that your resume clearly supports your responses to all of the questions by addressing your work experience in detail. We cannot make assumptions regarding your qualifications.
- Transcript (required) - Transcript must include the following information to be considered acceptable: student's name, college/university name, degree obtained, and date degree conferred.
- VA Form 10-2850a (required prior to job offer) - Application for Nurses and Nurse Anesthetists can be found at: https://www.va.gov/vaforms/medical/pdf/vha-10-2850a-091998-fill.pdf.https://www.va.gov/vaforms/medical/pdf/vha-10-2850a-091998-fill.pdf
- If you are a current federal employee, include your latest SF-50 Notification of personnel action that shows your current title, series, grade, step, salary, and tenure. (required)
- If you are a former federal employee, include your last SF-50 Notification of personnel action that shows your title, series, grade, step, salary, and tenure. (required)
- SF-50, Notification of Personnel Action (if applicable for Time in Grade and/or Eligibility):
- Most recent SF-50 if you are a current or former Federal employee
- An SF-50 showing your time-in-grade eligibility must be submitted with your application materials. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade.
- Award 50's do not provide sufficient information and will not be accepted for the purpose of verifying time-in-grade.
- Examples of appropriate SF-50's include:
  - Within grade increases at the highest grade held; r
  - Promotions with an effective date more than one year old; or
  - SF-50's at the highest grade held with an effective date mre than one year old.
- If prior military service, include all copies of your DD Forms 214 that shows your character of service (i.e. Honorable, Under Honorable Conditions) (required). If you are claiming 10-point Veterans' preference, in addition to your DD214, you must submit an SF-15, Application for 10-Point Veteran Preference, along with all required supporting documentation available at http://www.opm.gov/forms/pdf_fill/SF15.pdf.
The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. Please use this checklist to ensure you have included all documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50's (current/former Federal employees), etc.
- Cover Letter
- DD-214/ Statement of Service
- Disability Letter (VA)
- License
- Other (1)
- Performance Appraisal
- Professional Certification
- Resume
- SF-15
- SF-50/ Notification of Personnel Action
- Transcript
Veterans' Preference: When applying for Federal Jobs, eligible Veterans should claim preference for 5pt (TP), 10pt (CP/CPS/XP), or for Sole Survivor Preference (SSP) in the questionnaire. You must provide a legible copy of your DD214(s) which shows dates and character of service (honorable, general, etc.). If you are currently serving on active duty and expect to be released or discharged within 120 days you must submit documentation related to your active duty service which reflects the dates of service, character of service (honorable, general, etc.), and dates of impending separation. Additionally, disabled veterans and others eligible for 10-point preference (such as widows or mothers of eligible Veterans) must also submit an SF-15 "Application for 10 Point Veteran Preference" with required proof as stated on the form. Documentation is required to award preference. For more information on Veterans' Preference, please visit http://www.fedshirevets.gov/job/vetpref/index.aspx.
If you are relying on your education to meet qualification requirements:
Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education.
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
Benefits
Benefits
A career with the U.S. Government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Learn more about federal benefits.
Review our benefits
Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time, or intermittent. Contact the hiring agency for more information on the specific benefits offered.

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