Medical Coder III

Description

SAIC is looking for a Full-Time Remote Medical Coder III who has experience in coding inpatient professional, inpatient facility, same day surgeries, observation, Emergency Department, outpatient specialty, (ERSA), and billable outpatient primary care encounters

Qualifications:

• Advanced knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM), and Procedural Coding System (PCS); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT).

• Advanced knowledge of reimbursement systems, including Prospective Payment System (PPS) and Diagnostic Related Groupings (DRGs); Ambulatory Payment Classifications (APCs); and Resource-Based Relative Value Scale (RBRVS).

• Advanced knowledge and understanding of industry nomenclature; medical and procedural terminology; anatomy and physiology; pharmacology; and disease processes.

• Practical knowledge of medical specialties; medical diagnostic and therapeutic procedures; ancillary services (includes, but is not limited to, Laboratory, Occupational Therapy, Physical Therapy, and Radiology); and revenue cycle management concepts.

• Practical knowledge and understanding of Government rules and regulations regarding medical coding, reimbursement guidelines, and healthcare fraud; commercial reimbursement guidelines and policies; coding audit principles and concepts, and potential areas of risk for fraud and abuse. Includes, but is not limited to: The Federal Register, Center for Medicare, and Medicaid Services (CMS) Local Coverage Determinations and National Coverage Determinations (LCD and NCD), National Correct Coding Initiative (NCCI) guidance, manual, and edits, Internet-Only Manuals (IOMs), and HHS-OIG publications and reports.

• Practical knowledge of revenue cycle management, project management concepts, business analysis, training methods, clinical documentation improvement, and continuous process improvement processes.

• Practical knowledge of Current Dental Terminology (CDT).

Qualifications

Position Requirements

• A minimum of five (5) years of medical coding and/or auditing experience in four or more medical, surgical, and ancillary specialties within the past fifteen (15) years.

• A minimum of one (1) year of performance in the specialty is required to be qualifying. Multiple specialties encompass different medical specialties (i.e., Family Practice, Pediatrics, Gastroenterology, OB/GYN, etc.) that utilize ICD, E&M, CPT, and HCPCS codes. Ancillary specialties (PT/OT, Radiology, Lab, Nutrition, etc.) that usually do NOT use E&M codes do not count as qualifying experience. Coding experience should include inpatient facility and ambulatory surgery areas. Additionally, coding, auditing, and training exclusively for specialties such as home health, skilled nursing facilities, and rehabilitation care will not be considered as qualifying experience. Coding experience limited to making codes conform to specific payer requirements for the business office (insurance billing, accounts receivable) is not a qualifying factor.

****** Medical coding personnel shall maintain the required continuing education hours in order to maintain current and proper national certification (requirements for this position).**

Possesses Coding Certifications from 2 out of the 3 categories below:

1. RHIT/RHIA/CPC/CCS-P

2. RHIT/RHIA/CIC/CCS

3. CEMA/CPMA

Selected applicant must do the following before starting, based on government requirements:

• Pass a pre-employment coding test

• Provide proof of specific vaccinations

• The selected applicant will be subject to a government security investigation and must meet eligibility requirements

SAIC accepts applications on an ongoing basis and there is no deadline.

Covid Policy: SAIC does not require COVID-19 vaccinations or boosters. Customer site vaccination requirements must be followed when work is performed at a customer site. REQNUMBER: 2405402

SAIC is a premier technology integrator, solving our nation's most complex modernization and systems engineering challenges across the defense, space, federal civilian, and intelligence markets. Our robust portfolio of offerings includes high-end solutions in systems engineering and integration; enterprise IT, including cloud services; cyber; software; advanced analytics and simulation; and training. We are a team of 23,000 strong driven by mission, united purpose, and inspired by opportunity. Headquartered in Reston, Virginia, SAIC has annual revenues of approximately $6.5 billion. For more information, visit ~~~. For information on the benefits SAIC offers, see Working at SAIC. EOE AA M/F/Vet/Disability