Medical Coder III

Description

SAIC is looking for a Full-Time Remote Medical Coder III to provide remote medical coding support to government Medical Treatment Facilities assigned under the Defense Health Agency (DHA) Medical Coding Program Branch.

Applicants must have experience in multiple coding modalities / specialties, such as : inpatient professional, inpatient facility, same day surgeries, observation, Emergency Department, outpatient specialty / primary care encounters.

Qualifications :

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).

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).

Advanced knowledge and understanding of industry nomenclature; medical and procedural terminology; anatomy and physiology;

pharmacology; and disease processes.

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 concepts.

Practical knowledge and 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.

Includes, but is not limited to : The Federal Register, Center for Medicare, and Medicaid Services (CMS) Local Coverage Determinations and National Coverage Determinations (LCD and NCD), National Correct Coding Initiative (NCCI) guidance, manual, and edits, Internet-Only Manuals (IOMs), and HHS-OIG publications and reports.

• Practical knowledge of revenue cycle management, project management concepts, business analysis, training methods, clinical documentation improvement, and continuous process improvement processes.
• Practical knowledge of Current Dental Terminology (CDT).

Qualifications

Experience Requirements :

• A minimum of five (5) years of medical coding and / or auditing experience in four or more medical, surgical, and ancillary specialties within the past fifteen (15) years.
• A minimum of one (1) year of performance in the specialty is required to be qualifying. 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.

Certifications :

Applicants must have ONE of the following medical coding certifications :

RHIT / RHIA / CPC / CCS-P / CDEO / CDEI / ACDIS / CCDS / CCDS-O / CDIP / CEMA

Applicants who possess multiple certifications from the list above are preferred.

Medical coding personnel shall maintain the required continuing education hours in order to maintain current and proper national certification (requirements for this position).

Selected applicant must do the following before starting, based on government requirements :

• Pass a pre-employment coding test
• Provide proof of specific vaccinations
• The selected applicant will be subject to a government security investigation and must meet eligibility requirements

Target salary range : $50,001 - $75,000. The estimate displayed represents the typical salary range for this position based on experience and other factors.

SAIC accepts applications on an ongoing basis and there is no deadline.

Covid Policy : SAIC does not require COVID-19 vaccinations or boosters. Customer site vaccination requirements must be followed when work is performed at a customer site.