Outpatient Medical Coder in Crestview, FL at Maximus

Date Posted: 2/23/2021

Job Snapshot

Job Description

Responsible for assignment of accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic) for outpatient encounters. Trains and educates MTF staff on coding issues and plays a significant role in
coding compliance activities.

Job duties
•Responsible for assignment of accurate E&M, ICD, CPT and HCPCS codes and modifiers from medical record documentation.
•Identifies and abstracts information from medical records (paper or electronic) for special studies and audits, internal and external.
•Interacts with MTF staff to ensure documentation is clear and supports coding assignments.
•Educates MTF staff through individual or group in-services and training sessions.
•Maintains a delinquency report of missing records in order to facilitate completion of work within the required thresholds.

•Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC) CCS-P (Certified Coder Specialist – Physician (CCS-P) with the appropriate level of experience.
•An accrediting institution recognized by the American Health Information Management Association (AHIMA) and/or American Academy of Professional Coders (AAPC) must accredit education.
•Contract medical coders will obtain the required continued education hours at no expense to the government in order to maintain current and proper national certification(s) required for the position.

•A minimum of two (2) to three (3) year experience in the outpatient setting (physician’s office or ambulatory surgery centers) within the last five years, including assignment of E&M, CPT, and HCPCS codes.
•Multiple specialties encompass different medical specialties (i.e. Family Practice, Pediatrics, Gastroenterology, OB/GYN, etc.) that utilize ICD, E&M, CPT, and HCPCS codes.
•Ancillary specialties (PT/OT, Radiology, Lab, Nutrition, etc.) that usually do NOT use E&M codes do not count as qualifying experience.
•Additionally, coding, auditing and training exclusively for specialties such as home health, skilled nursing facilities, and rehabilitation care will not be considered as qualifying experience.
•Coding experience limited to making codes conform to specific payer requirements for the business office (insurance billing, accounts receivable) is not a qualifying factor.
•Two years of outpatient/ambulatory surgery experience may be qualifying if received in a military medical facility.
•Position requires excellent computer/communication skills for provider and staff interactions.
•Knowledge of anatomy/physiology and disease process, medical terminology, coding guidelines (outpatient), documentation requirements, familiarity with medications and reimbursement guidelines; and encoder experience.
•Candidate must have ability to handle multiple projects and appropriately prioritize tasks to meet deadlines.

Unique Military Health Care Systems
•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 a 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)


Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.

Minimum Requirements:
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.

MAXIMUS Introduction
Since 1975, Maximus has operated under its founding mission of Helping Government Serve the People, enabling citizens around the globe to successfully engage with their governments at all levels and across a variety of health and human services programs. Maximus delivers innovative business process management and technology solutions that contribute to improved outcomes for citizens and higher levels of productivity, accuracy, accountability and efficiency of government-sponsored programs. With more than 30,000 employees worldwide, Maximus is a proud partner to government agencies in the United States, Australia, Canada, Saudi Arabia, Singapore and the United Kingdom. For more information, visit https://www.maximus.com.
EEO Statement: Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We’re proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.


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