Medical Coding Compliance Specialist - Lead

11 - 15 years experience  •  Business Services

Salary depends on experience
Posted on 09/21/17
11 - 15 years experience
Business Services
Salary depends on experience
Posted on 09/21/17

About Engility

Engility delivers innovative solutions to critical challenges facing the nation and the world. As a premier provider of integrated services for the U.S. government, we support the Department of Defense, intelligence community, space communities, federal civilian agencies and international customers. Engility is dedicated to making lives better, safer and more secure.

Description

Medical coding compliance consists of providing analysis, auditing, investigation, recommendations, research, and other support to ensure observance or conformity with official coding policies, regulations, requirements, and standards. Revenue integrity consists of providing analysis, auditing, investigation, recommendations, research, and other support to prevent or recapture lost revenue from healthcare operations.

Issues Log: As part of continuous improvement efforts, all contractor personnel in this contract will be required to maintain and submit a weekly issues log IAW the AFMS Coding Manual, to be received by the AFMS MCPO.

  1. Attend meeting(s) and manage contractor personnel
  2. Prepare and provide human resource plan
  3. Provide general consultation and technical guidance in the establishment of new or redefined AFMS MCPO operating program guides, policies and procedures
  4. Plan and conduct projects to gather and analyze data which will improve organizational performance
  5. Conduct or participate in reviews and evaluations of AFMS MCPO operations to determine progress, conformity to program requirements and identifies deficiencies and problems affecting cost and delivery of services.
  6. Recommend corrective action and methods to resolve problems and achieve compliance with policy. Prepare communication for widespread distribution within the organization.
  7. Assists with developing, editing, maintaining, and updating coding compliance plans
  8. Prepare reports associated with projects conducted and related to productivity, operations, and utilization of resources to determine the effectiveness of programs and to resolve problems of significant consequences.
  9. Audit Reports. Where contractor personnel perform medical coding audits, an audit report will be required to be completed IAW the AFMS Coding Manual
  10. Project Reports. Where contractor personnel perform projects involving qualitative research and analysis to develop conclusions and recommendations, a project report will be required to be completed.
  11. Issues Log. As part of continuous improvement efforts, all contractor personnel in this contract will be required to maintain and submit a weekly issues log IAW the AFMS Coding Manual, to be received by the AFMS MCPO.
  12. Acts as liaison between contractor management staff and the Government, and will have supervisory authority over the other Medical Coding Compliance Specialist contract personnel performing under this contract.
  13. Works with contractor management staff and the Government in design, execution, and monitoring of training or individual development plans of assigned Medical Coding Compliance Specialist personnel under this contract.
  14. Assists the AFMS MCPO by researching and developing compliance and compliance training programs, and assists with developing and monitoring the AFMS coding compliance plan. Leads other Medical Coding Compliance Specialists in conducting assessments to identify new development needs and makes recommendations accordingly.

Required Qualifications

Education, A minimum of one of the following:

  1. An associate’s degree in Health Information Management;
  2. A university certificate in medical coding;
  3. At least 30 semester hours’ university/college credit that includes relevant coursework such as anatomy/physiology, medical terminology, health information management, and/or pharmacology; OR
  4. Completion of American Health Information Management Association (AHIMA) and/or American Academy of Professional Coders (AAPC) coding exam preparation courses that include the above coursework and lead to successful course completion and coding certification may be accepted in lieu of university/college credit by the AFMS MCPO on a case-by-case basis.

Experience:

  1. A minimum of 10 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 5 years of experience in a training role (training auditors, coders, and/or providers), or a minimum of 3 years’ training experience within the last 6 years in a military coding environment.
  2. A minimum of 1 year of performance in the specialty is required to be qualifying. Training expertise must include identifying coding training opportunities; developing training plans and material, and instruction/delivery of the training to medical coder and clinical audiences.
  3. A minimum of 10 years of coding experience that includes 5 years of training, auditing, or compliance experience, a minimum of 2 years of that experience must include performance of lead or supervisory tasks
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