Summary About the Position: This position falls under the Defense Health Agency (DHA) Atlantic Network serving the Naval Medical Center Portsmouth, Virginia functioning primarily as a medical auditor/trainer under the Directorate of Administration.
This is a Direct Hire Solicitation
Learn more about this agency Duties Help
- Analyze patient medical records to identify inaccurately coded services in accordance with federal coding regulations and guidelines.
- Assign specific codes to medical records, sequencing and determining codes to accurately reflect the resources and procedures used in the care of the patients.
- Ensure compliance with regulatory and third-party insurance requirements in utilizing the ICD-10-CM, and CPT coding books.
- Perform limited utilization review of outpatient and inpatient records to assure the diagnosis responsible for the length of stay is appropriately identified.
- Assure secondary diagnoses are sequenced properly to assure maximum allocation under the Relative Value Unit (RVU) and Diagnosis-Related Group (DRG) systems.
- Provide review and analysis of coding accuracy and compliance statistics, coordinating results with the Coding Manager and Patient Administration Department Head for feed back to the providers.
- Prepare reports of findings and recommends staff education and training on accurate coding practices and compliance issues to maintain coding accuracy.
- Provide monthly performance and progress reports addressing levels of accomplishment to Coding Manager and Patient Administration Department Head.
- Maintain thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques through participation in continuing education programs.
- Maintain a thorough understanding of medical record practices, standards, regulations, and Joint Commission requirements.
- Perform diagnosis and procedure coding through application of International Classification of Diseases, Clinical Modification (ICD-11-CM) current edition and Current Procedural Terminology (CPT) coding guidelines.
- Develop programs and plans for training medical and ancillary services staff in basic coding techniques and requirements.
- Work in coordination with the government electronic health record sustainment trainer as appropriate and recommends coding resources to enhance data quality.
Requirements Help
Conditions of employment - Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation.
- This position requires the incumbent be able to obtain and maintain a determination of eligibility for a Secret security clearance or access for the duration of employment. A background investigation and credit check are required.
- Immunization screening is required. Hepatitis B immunization is required for all positions with direct patient contact. Applicants may be required to show proof of other immunizations depending on the type of position.
- This position has mandatory seasonal Influenza vaccination requirements and is subject to annual seasonal Influenza vaccinations unless otherwise exempted for medical or religious reasons (documentation of exemption must be provided upon hire).
- This position requires the incumbent to have Tuberculosis testing.
- Nationally recognized medical coding certification from AHIMA or AAPC highly desired but not required.
Qualifications Who May Apply: US Citizens In order to qualify, you must meet the experience requirements described below. 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; religious; spiritual; community; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document.
SPECIALIZED EXPERIENCE: One year of specialized experience which includes, 1) Assisting in auditing coders and/or providers to identify inaccurately coded services in accordance with coding regulations; 2) Identifying errors, trends, and/or concerns regarding diagnosis, Current Procedural Terminology (CPT), Evaluation and Management (E/M) errors and converting that data into training material;
and 3) Providing guidance and functional knowledge to improve coding accuracy.
This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-06).
Education Some federal jobs allow you to substitute your education for the required experience in order to qualify. For this job, you must meet the qualification requirement using experience aloneno substitution of education for experience is permitted.
Additional information - Male applicants born after December 31, 1959 must complete a Pre-Employment Certification Statement for Selective Service Registration.
- You will be required to provide proof of U.S. Citizenship.
- This position requires a 1 year probationary period during which the agency evaluates your fitness and whether your continued employment advances the public interest. In making this determination, the agency may consider your performance and conduct; agency needs and interests; whether your continued employment supports organizational or Government goals; and whether it promotes the efficiency of the Federal service. Continued employment requires written certification that it advances the public interest.
- Direct Deposit of Pay is required.
- Selection is subject to restrictions resulting from Department of Defense referral system for displaced employees.
- Recruitment incentive MAY be authorized for highly qualified candidates.
- Advanced In-Hire MAY be authorized for highly qualified candidates.
- Multiple positions may be filled from this announcement.
- Salary includes applicable locality pay or Local Market Supplement.
- If you have retired from federal service and you are interested in employment as a reemployed annuitant, see the information in the Reemployed Annuitant information sheet.
- Payment of Permanent Change of Station (PCS) costs is not authorized, based on a determination that a PCS move is not in the Government interest.
Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.
Help
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