医疗编码审计员 / 编码验证评审员
Medical Coding Auditor / Coding Validation Reviewer
职位概述
职位概述：
地点：100% 远程（仅限美国），支持VISN 7区域的VA医疗中心。期限：12个月基础期，加上四个12个月的可选期。薪资：每小时25.00美元至30.00美元
关于该职位
Aptive Resources 正在寻找有经验的编码审计人员，为佐治亚州、阿拉巴马州和南卡罗来纳州的美国退伍军人事务医疗中心进行外部编码审计。您将对住院DRG、门诊和专业费用编码进行审计，报告发现的问题，并教导VA的编码人员和临床医生如何改进。VA预计每年在亚特兰大、伯明翰、哥伦比亚和奥古斯塔设施中审计约5,000条记录。
主要职责
您将负责
- 独立于常规编码工作，对编码数据的准确性和合规性进行审计。每次审计专注于一个领域：住院机构（DRG）、门诊机构、包括手术在内的住院专业服务，或门诊服务（急诊、诊所就诊和日间手术）。
- 每个记录审查最多前25个诊断和前25个操作，适用于机构和专业服务。
- 协助建立统计上有效的样本（95%置信水平，至少占记录的10%）和数据收集工具。
- 在审计开始前，审查每个机构的HIMS政策和编码程序。
- 将错误分类为编码、诊断、修饰符、文档或合规性错误，并用编码参考资料支持每项错误。
- 编写涵盖准确性、财务影响和关注领域的机构审计报告，并为全网络报告做出贡献。
- 在审计结束后7个工作日内与HIMS主管、COR和机构负责人讨论初稿结果，并在15个工作日内提交最终报告。
- 制定机构特定的培训计划，并使用真实病历，为编码人员、管理人员和医生开展至少2小时的“培训者培训”教育课程。
- 与健康信息管理领导层举行退出会议。
最低要求
必备资格
- 持有活跃的RHIA、RHIT、CCS、CCS-P、CPC或CPC-H认证。
- 至少3年作为顾问审核大型三级医院和覆盖所有亚专科及初级护理的门诊机构记录的经验。
- 至少3年的教育和培训经验，例如教授编码员或医护人员。
- 至少3年的编码经验。
- 两个可以证明您审计工作的当前客户推荐人。这些是 su
查看英文原文
Job Summary
Job Summary:
Location: 100% remote (US only), supporting VA medical centers in VISN 7 Term: 12-month base period plus four 12-month option periods. Pay: 25.00/hr-30.00/hr
About the role
Aptive Resources is looking for experienced coding auditors to run external coding audits for Veterans Affairs medical centers in Georgia, Alabama, and South Carolina. You'll audit inpatient DRG, outpatient, and professional fee coding, report what you find, and teach VA coding staff and clinicians how to improve. The VA expects about 5,000 audited records a year across the Atlanta, Birmingham, Columbia, and Augusta facilities.
Primary Responsibilities
What you'll do
- Audit coded data for accuracy and compliance, separately from the regular coding work. Each audit focuses on one area: inpatient facility (DRG), outpatient facility, inpatient professional services including surgery, or outpatient services (urgent care, clinic visits, and ambulatory surgery).
- Review up to the first 25 diagnoses and the first 25 procedures on each record, for both facility and professional services.
- Help build statistically valid samples (a 95% confidence level, and at least 10% of records) and data collection tools for each audit.
- Review each facility's HIMS policies and coding procedures before the audit starts.
- Classify errors as coding, diagnosis, modifier, documentation, or compliance errors, and back up each one with coding references.
- Write facility audit reports covering accuracy, financial impact, and areas of concern, and contribute to a network-wide report.
- Go over draft findings with the HIMS Chief, COR, and facility leaders within 7 business days of the audit, and deliver final reports within 15 business days.
- Create facility-specific training plans, and lead "train the trainer" education sessions of at least 2 hours, using real charts, for coding staff, managers, and physicians.
- Run exit conferences with Health Information Management leadership.
Minimum Qualifications
Required qualifications
- An active RHIA, RHIT, CCS, CCS-P, CPC, or CPC-H credential.
- At least 3 years of experience as a consultant reviewing records for large tertiary care hospitals and outpatient organizations that cover all subspecialties and primary care.
- At least 3 years of education and training experience, such as teaching coders or providers.
- At least 3 years of coding experience.
- Two current client references who can speak to your audit work. These are submitted with the contract proposal.
- Proof of active credentials, plus a current resume for the proposal.
- Completion of an accredited coding, HIM, or health information technician program.
- Expertise in ICD-10-CM/PCS, CPT, HCPCS, DRG/MS-DRG, APC, E/M, and NCCI edits.
- US citizenship, and the ability to pass a federal background investigation (NACI) and fingerprinting.
Preferred qualifications
- An auditing credential such as CDIP, CPMA, or CIC, in addition to a required credential.
- Experience auditing for the VA or another federal health system.
- Strong report writing and presentation skills, including explaining findings in plain language for non-coders.
Additional requirements
- Complete the VA's annual Privacy and Information Security Awareness and HIPAA training (TMS 10176 and 10203).
- Travel to VA facilities only when the government authorizes it. Approved travel is reimbursed under federal travel regulations.
About Aptive
Arrow ARC supports Veterans Health Administration facilities and offices across the U.S. with health care staffing and program support via the 10-year Integrated Critical Staffing Program (ICSP). We provide staffing solutions to address critical shortages in VHA medical facilities caused by turnover, recruitment issues, seasonal needs, surges or emergencies.
Arrow is a certified Service-Disabled, Veteran-Owned Small Business joint venture between Artemis ARC and Aptive Resources, two award-winning companies that share an agile, mission-focused, results driven approach in the federal sector. Arrow provides management consulting services and specializes in working with federal government agencies like the Department of Veterans Affairs and Office of Personnel Management.
EEO Statement
Aptive is an equal opportunity employer. We consider all qualified applicants for employment without regard to race, color, national origin, religion, creed, sex, sexual orientation, gender identity, marital status, parental status, veteran status, age, disability, or any other protected class.
Veterans, members of the Reserve and National Guard, and transitioning active-duty service members are highly encouraged to apply.
Originally posted on Himalayas