Dha Medical Coding Compliance Specialist - Washington, United States - Serco North America

Serco North America

Verified Company

Washington, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Position Description:
Serco is excited to continue our support to the Defense Heath Agency (DHA) Medical Coding Program Branch.

The DHA is a joint, integrated Combat Support Agency that enables the Army, Navy, and Air Force medical services to provide a medically ready force to Combatant Commands in both peacetime and wartime.

The essential mission of the DHA Medical Coding Program Branch (DHA-MCPB) is to improve the accuracy and quality of medical coding and documentation across DHA in support of the DHA mission.

This is a 100% Remote position.

Our Medical Coding Compliance Specialists seek to prevent activity or actions in medical coding and documentation that could lead to fraud, waste, or abuse.

It involves performing analysis, auditing, investigation, research, reporting, and other tasks to support development, implementation, operation, and oversight of DHA medical coding compliance.

In this role, you will:

The work will encompass all 400 Military Treatment Facilities and Dental clinics assigned to DHA Markets.
The work may include multiple conference calls, virtual meetings, and onsite visits to DHA organizational elements inside the continental United States (CONUS) and outside of the continental United States (OCONUS).
Specifically, the work of the Medical Coding Compliance Specialists involves significant use of computers; review of Federal laws, regulations, guidance, publications, and standards; industry guidelines, publications, and standards; development of position papers, reports, and analyses; perform investigations and provide findings on reports of noncompliance with DHA coding and documentation guidance, instructions, policies, procedures, and standards; development and performance of revenue integrity projects; and analysis, evaluation, review, and recommendations for changes and updates to the CDM and other systems and processes impacting medical coding.

Qualifications:
To be successful in this role, you will have:

Or a university, college, or technical school certificate in medical coding
Or at least 30 semester hours' university/college credit of a grade of "C", "Pass", or better, that includes relevant coursework such as anatomy/physiology, medical terminology, health information management, and/or pharmacology
Or successful completion of an American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) online or inperson coding exam preparation course that includes medical terminology, anatomy and physiology, health information management concepts, and pharmacology
Or successful completion of a training course beyond apprentice level for medical technicians, hospital corpsmen, medical service specialists, or hospital training, obtained in a training program given by the Armed Forces or the U.S. Maritime Service under close medical and professional supervision.

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Pre-employment Coding Compliance Specialist Test:

Posses a NACI clearance
Up to 10% travel

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Professional Services

Coding Certifications:

ONE** of the following recognized professional coding certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Professional Coder (CPC); or Certified Coding Specialist - Physician (CCS-P).

Other professional coding certifications will be considered by the DHA-MCPB on a case-by-case basis.
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Institutional (Facility)

Coding Certifications:

ONE** of the following recognized institutional coding certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Inpatient Coder (CIC), or Certified Coding Specialist (CCS).

Other institutional coding certifications will be considered by the DHA-MCPB on a case-by-case basis.
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Coding Compliance Certifications:ONE **of the following recognized coding compliance certifications:

AAPC:
Certified Professional Compliance Officer (CPCO)

Health Care Compliance Association (HCCA):
Certified in Healthcare Compliance (CHC)
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Evaluation and Management Auditing Certification:

National Alliance of Medical Auditing Specialists' (NAMAS) Certified Evaluation and Management Auditor (CEMA).

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Continuing Education Requirements:

Medical coding personnel shall maintain the required continuing education hours in order to maintain current and proper national certification(s) requirements for this position at no expense to the Government.
A minimum of ten years of medical coding and/or auditing experience in two or more medical, surgical, and ancillary specialties within the past 15 years, including at least five (5) years of experience in an auditing, training, or compliance role
OR a minimum of three (3) years of auditing, training, and/or compliance experience within the last six (6) years in a military coding environment.
When claiming medical coding experience, a minimum of one (1) year of performanc