About the position
Compass Government Solutions, LLC is looking for a highly experienced and detail-oriented Remote Medical Coder II/Auditor eager to be included in our proposal as an interested and skilled individual to service the Defense Health Agency (DHA). Successful candidates will be responsible for accurately coding and auditing medical records across multiple specialties, ensuring compliance with all applicable regulations, and maximizing reimbursement. This role requires advanced knowledge of coding systems and reimbursement methodologies, as well as a strong commitment to accuracy and efficiency.
Responsibilities
- Ensure coding accuracy, completeness, productivity, and timeliness in accordance with DHA standards and DoDI 6040.42.
- Code records for services in areas such as Laboratory, Radiology, and Dental.
- Assign correct Ambulatory Payment Classifications (APCs) and Relative Value Units (RVUs) for accurate reimbursement or workload credit.
- Perform coding tasks within MHS GENESIS® and other military coding systems (3M Encompass 360, Joint Legacy Viewer (JLV)).
- Research and resolve coding edit failures as assigned.
- Apply advanced knowledge of ICD-10-CM, HCPCS, and CPT coding systems for both institutional and professional medical coding.
- Utilize advanced knowledge of reimbursement systems, including PPS, APCs, and RBRVS, to ensure accurate billing and revenue capture.
- Apply expert understanding of industry nomenclature, medical and procedural terminology, anatomy, physiology, pharmacology, and disease processes to coding and auditing tasks.
- Demonstrate practical knowledge of medical specialties, medical diagnostic and therapeutic procedures, and ancillary services (Laboratory, Dental, Occupational Therapy, Physical Therapy, Radiology) in relation to medical coding.
- Apply practical knowledge of revenue cycle management concepts to medical coding practices.
- Maintain compliance with government and commercial reimbursement guidelines and regulations, including The Federal Register, CMS Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs), National Correct Coding Initiative (NCCI) guidance, manuals, and edits, Internet-Only Manuals (IOMs), HHS-OIG publications and reports.
- Conduct coding audits, identifying and correcting errors, and mitigating fraud and abuse risks.
- Implement and support clinical documentation improvement initiatives.
- Contribute to continuous process improvement efforts within the medical coding department.
- Utilize practical knowledge of EHR systems and workflows related to medical coding.
Requirements
- High School Diploma or equivalent.
- Minimum of four (4) years of medical coding and/or auditing experience in two (2) or more medical, surgical, and ancillary specialties within the past 10 years; OR a minimum of two (2) years of medical coding or auditing experience if that experience was in a Military Treatment Facility (MTF).
- A minimum of one (1) year of documented performance in a medical specialty is required to be considered qualifying.
- Strong knowledge of ICD-10-CM, HCPCS, and CPT coding systems.
- Understanding of ambulatory payment classifications (APCs) and other relevant reimbursement methodologies.
- Knowledge of medical terminology, anatomy, and physiology.
- Strong attention to detail and accuracy.
- Excellent analytical and problem-solving skills.
- Completion of a recognized coding certification preparation course through the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA); OR Completion of an advanced medical training course (e.g., for medical technicians, hospital corpsmen) from the Armed Forces or U.S. Maritime Service.
Nice-to-haves
- Strong analytical and problem-solving skills.
- Excellent communication and interpersonal abilities.
- Proficiency in medical coding software and electronic health record systems.
Benefits
- Competitive Salary
- Accrued paid time off
- Paid Federal Holidays
- Health and Wellness benefit to help cover medical costs
- Dental and Vision Plans
- 401k Plan
