Medical Coder I

Medical Coder I

Department of Defense (DoD)

Defense Health Agency (DHA)

Specifically supporting the DHA Medical Coding Program Branch (DHA-MCPB)

Place of Performance: Remote / Off-site performance

Period of Performance: One (1) year base period, with the possibility of one (1) additional option year.

Schedule: Coding services may be performed Monday–Friday, excluding federal holidays

Requirements:

• minimum of three (3) 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 Military Treatment Facility (MTF). A minimum of one (1) year of performance in the specialty is required to be documented to be considered qualifying.
• Professional services coding certification, such as:
• CPC® (AAPC)
• CCS® (AHIMA)
• Facility coding certification is not required at this level

Duties and Responsibilities will include, but are not limited to the following:

• Accurately assigns diagnosis and procedure codes for facility and professional services for outpatient specialty any outpatient primary care encounters billable to a third party IAW DHA accuracy, completeness, productivity, and timeliness standards contained in DoDI 6040.42, Management Standards for Coding of DoD Health Records.
• Performs necessary tasks within MHS GENESIS® and other military coding systems (to include, but not limited to, 3M Encompass 360, Joint Legacy Viewer (JLV)) to complete encounters.
• Researches and resolves MHS GENESIS coding edit failures as assigned.
• Review medical documentation and codes for compliance with federal coding regulations and DoD guidelines.
• Obtain clarification of conflicting, ambiguous, or non-specific documentation.
• Maintain required productivity standards per DoD requirements. Contractor productivity requirement will be to complete 80% or more of assigned workload within a performance period (quarter). Maintain timeliness standards per DoD requirements.
• Maintain accuracy standards per DoD requirements. Accuracy standards will be 97% overall accuracy of diagnosis, Evaluation & Management (E&M), and procedure codes; modifiers; and quantities or units of service.

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