Veterans Affairs, Veterans Health Administration, Department of Veterans Affairs
The Coding Auditor is responsible for auditing inpatient (Community Living Center & Domiciliary) and outpatient encounters for billable and non-billable care provided at a complexity level 3, affiliated, health care system.
Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of a health records.
An associate's degree from an accredited college or university recognized by the U.S.
Department of Education with a major field of study in health information technology/health information management, or a related degree with a minimum of 12 semester hours in health information technology/health information management (e.g., courses in medical terminology, anatomy and physiology, medical coding, and introduction to health records); OR, (3) Completion of an AHIMA approved coding program, or other intense coding training program of approximately one year or more that included courses in anatomy and physiology, medical terminology, basic ICD diagnostic/procedural, and basic CPT coding.
The training program must have led to eligibility for coding certification/certification examination, and the sponsoring academic institution must have been accredited by a national U.S.
Department of Education accreditor, or comparable international accrediting authority at the time the program was completed; OR, (4) Experience/Education Combination.
Equivalent combinations of creditable experience and education are qualifying for meeting the basic requirements.
The following educational/training substitutions are appropriate for combining education and creditable experience: (a) Six months of creditable experience that indicates knowledge of medical terminology, general understanding of medical coding and the health record, and one year above high school, with a minimum of 6 semester hours of health information technology courses.
(b) Successful completion of a course 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, may be substituted on a month-for-month basis for up to six months of experience provided the training program included courses in anatomy, physiology, and health record techniques and procedures.
Also, requires six additional months of creditable Certification.
Persons hired or reassigned to MRT (Coder) positions in the GS-0675 series in VHA must have either (1), (2), or (3) below: (1) Apprentice/Associate Level Certification through AHIMA or AAPC.
(2) Mastery Level Certification through AHIMA or AAPC.
(3) Clinical Documentation Improvement Certification through AHIMA or ACDIS.
NOTE: Mastery level certification is required for all positions above the journey level; however, for clinical documentation improvement specialist assignments, a clinical documentation improvement certification may be substituted for a mastery level certification.
May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria).
Preferred Experience: Ability to extract ICD-10 CM and Current Procedural Terminology codes from provider progress notes and other medical data reports.
Ability to analyze and report data.
Ability to write executive summaries.
Ability to work well with people.
Ability to train and educate staff from a variety of areas.
Must be certified.
Grade Determinations:nMedical Records Technician (Coder) Auditor, GS-9 (a) Auditor assignments can be established for any of the coder subspecialties (outpatient, inpatient, or outpatient and inpatient combined).
The subspecialty will be reflected in the title, e.g., MRT (Coder) Auditor (Outpatient).
One year of creditable experience equivalent to the journey grade level of a MRT (Coder).
Employees at this level must have a mastery level certification.
(d) Demonstrated Knowledge, Skills, and Abilities.
In addition to the experience above, the candidate must demonstrate all of the following KSAs: i.
Advanced knowledge of current coding classification systems such as ICD, CPT, and HCPCS for the subspecialty being assigned (outpatient, inpatient, outpatient and inpatient combined).
Ability to research and solve complex questions related to coding conventions and guidelines in an accurate and timely manner.
Ability to review coded data and supporting documentation to identify adherence to applicable standards, coding conventions and guidelines, and documentation requirements.
Ability to format and present audit results, identify trends, and provide guidance to improve accuracy.
Skill in interpersonal relations and conflict resolution to deal with individuals at all organizational levels.
References: VA Handbook 5005/122 December 10, 2019 PART II APPENDIX G57 The full performance level of this vacancy is GS-9.
Physical Requirements: Moderate lifting/carrying (15-44 lbs); reaching above the shoulder; use of fingers; walking/standing (up to 4 hours); near vision correctable at 13" to 16" to Jaeger 1 to 4; hearing (aid permitted).
How to Apply