OUTPATIENT MEDICAL CODER/AUDITOR

LTSi - Laredo Technical Services, Inc.•Quantico Base, VA

2d•$36 - $38•Onsite

About The Position

Laredo Technical Services, Inc. is hiring a full-time, on-site Outpatient Medical Coder/Auditor for Naval Health Clinic Quantico. The position operates from 7:30 a.m. to 4:30 p.m., Monday through Friday, excluding Federal Holidays, and is expected to start immediately after completion of required background and security investigations. The role supports outpatient coding and auditing in accordance with Defense Health Agency (DHA) and Air Force Medical Service Medical Coding Program Office (AFMS MCPO) requirements. The coder assigns accurate diagnosis, procedure, and supply codes for professional and institutional components of outpatient encounters; reviews records and documentation for coding support and clarity; and submits and tracks provider queries when clarification is needed. The role also supports coding compliance through focused audits, quality assurance and peer reviews, validation of flagged diagnosis codes, correction of coding-related write-back errors, and periodic reporting. The coder advises and educates providers and clinical staff on coding and documentation requirements, collaborates on training, researches coding guidance, and may assist with compiling and reporting coding data for performance purposes.

Requirements

Current coding certification in good standing: Certified Professional Coder (CPC) or Certified Coding Specialist–Physician (CCS-P).
Current Certified Evaluation and Management Auditor (CEMA) certification from the National Alliance of Medical Auditing Specialists (NAMAS).
At least three years of medical coding and/or auditing experience in two or more medical, surgical, and ancillary specialties within the past 10 years; at least one year of qualifying performance in the specialty.
Practical knowledge of ICD-CM, HCPCS, and CPT.
Practical knowledge of reimbursement systems, including Ambulatory Payment Classifications (APCs) and Resource-Based Relative Value Scale (RBRVS).
Practical knowledge of industry nomenclature; medical and procedural terminology; anatomy and physiology; pharmacology; and disease processes.
Practical knowledge of medical specialties, diagnostic and therapeutic procedures, ancillary services, and revenue cycle management.
Ability to meet applicable DHA and AFMS MCPO coding, documentation, audit, reporting, and compliance requirements.

Nice To Haves

Associate’s degree in Health Information Management.
University certificate in medical coding.
At least 30 semester hours of university or college credit, including relevant coursework such as anatomy and physiology, medical terminology, health information management, or pharmacology.
Successful completion of an AAPC or AHIMA coding certification preparation course for professional services or facility coding that includes medical terminology, anatomy and physiology, health information management concepts, and pharmacology.
RHIT or RHIA credential, which the posting states counts for either a professional services or institutional coding certification.

Responsibilities

Assign diagnosis, procedure, and supply codes for professional and institutional components of outpatient encounters in accordance with DHA and AFMS MCPO standards.
Follow accepted coding practices and guidelines to ensure ethical, accurate, and complete coding.
Monitor regulatory and policy requirements affecting coded information.
Review encounter and record documentation for inconsistencies, ambiguities, discrepancies, legibility issues, and sufficient support for diagnoses and services; bring documentation concerns to providers’ attention.
Examine records as needed for proper document sequence, authorized signatures, and sufficient supporting data.
Prepare, submit, monitor, and report provider queries requesting clarification of conflicting, ambiguous, or incomplete documentation.
Educate providers and clinical staff and provide feedback to address documentation issues and support coding compliance.
Assign codes based on provider query responses and report queries and responses according to guidance.
Answer medical staff questions about coding and provide appropriate coding and documentation references.
Identify training opportunities based on medical staff contacts and collaborate with coding trainers on initial and annual training for providers and clinical staff.
Research and interpret coding guidance, seeking clarification from the Lead Medical Coder, supervisor, or service coding representatives when appropriate.
Perform focused audits of MTFs, specialties, clinics, coders, or providers, as directed, and conduct quality assurance or peer reviews according to applicable requirements.
Complete administrative tasks related to medical-record final reviews and audits, including contacting departments, services, or medical staff to obtain necessary information.
Comply with coding compliance training and reporting requirements and assist with MTF compliance training and tracking as needed.
Correct coding-related write-back errors and track corrective action as applicable.
Use MHS computer systems to remotely access patient records and code encounters for other MTFs when directed by DHA or AFMS MCPO.
Review coding validation notifications, verify identified codes, make corrections when needed, and ensure encounters are corrected within three business days; provide provider training on the consequences of code use.
Provide or contribute to periodic reports in accordance with DHA and AFMS MCPO instructions and timelines.
Provide limited assistance compiling, analyzing, and reporting MTF coding data for performance purposes, as needed.