Medical Records (Coder-Auditor)

Work Schedule: 8:00am to 4:30pm, Monday-Friday Compressed/Flexible: Not Authorized Remote: These approved positions are currently designated for a mid-term extension to the return to office mandate through October 2025. While these positions may be filled as remote, the employee will be required to return to the office if the mid-term extension is not continued. Therefore, all applicants must be located within 50 miles of a VA facility. Telework: Once returned to the office Telework may be approved as ADHOC, depending on Supervisor approval. Virtual: This is not a virtual position. Functional Statement #: 10444-F Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS) Not Authorized PCS Appraised Value Offer (AVO): Not Authorized Major Duties include but are not limited to the following: Reviews coding and assist coders in improving coding accuracy; provides coding guidance to various levels of staff to promote consistency in practice and compliance with coding rules and regulations; initiates various reports and analyze data. Monitors ever-changing regulatory and policy requirements affecting coded information for the full spectrum of services provided by the VAMC. Reviews assigned codes from the current version of several coding systems to include current versions of the International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and/or Healthcare Common Procedure Coding System (HCPCS). Applies guidelines specific to certain diagnoses, procedures, and other criteria used to classify patients, under the Veterans Equitable Resource Allocation (VERA) program that categorizes all VA patients into specific classes representing their clinical conditions and resource needs. Responsible for performing audits of coded data, developing criteria, collecting data, graphing and analyzing results, creating reports, and communicating in writing and/or in person to appropriate leadership and groups. Audits accurate and complete assignment of ICD-10-CM, ICD-10-CPT and/or ICD-10-PCS codes, MS-DRG, POA status, and discharge disposition values for health records as assigned. Audit function includes evaluation of clinical documentation to support optimal code assignment. Maintains statistical database(s) to track the results and validate the program for identifying patterns and variations in coding practices with regular reports to the medical staff and management. Researches complex coding issues and participates in process improvements related to coding. Provides training and education to coding and clinical staff to improve coding accuracy.