Clarification from the agency

Open to current permanent VA Nationwide employees and Federal employees of other Agencies (1st Area of Consideration - current permanent employees of the Veterans Healthcare System of the Ozarks & associated CBOCs; 2nd Area of Consideration - current permanent VA Nationwide employees; 3rd Area of Consideration - current permanent Federal employees of other Agencies)

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If you are not a current, permanent VHA employee, or of another federal agency, you should apply under announcement CBST-11111498-21-AH.

Auditors serve as experts of current coding conventions and regulations related to professional and facility coding. Incumbent performs audits of encounters to identify areas of non-compliance in coding, and provides recommendations on appropriate coding and is responsible for maintaining current knowledge of the various regulatory guidelines and requirements.

Duties may include but are not limited to:

• Collaborates with staff to ensure that regulations are met, or areas of weakness are identified and reported to appropriate supervisor for corrective action.
• Performs prospective coding audits and utilizes results to identify processing inadequacies and re-educate coding staff where necessary.
• Coordinates retrospective reviews to ensure adequate auditing of coding activities.
• Acts independently to plan, organize, direct and control areas with emphasis on data validation, analysis and generation of reports associated with the Medical Center's health information management program.
• Determines quality control measures needed; initiates and implements them by use of monitors and/or continuous review.
• Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, & procedures as well as the principles and practices of health services and the organizational structure to ensure proper code selection.
• Selects and assigns codes from the current version of several coding systems to include current versions of the International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and/or Healthcare Common Procedure Coding System (HCPCS).
• Adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or Evaluation and Management code to ensure ethical, accurate, and complete coding.
• Monitors ever-changing regulatory and policy requirements affecting coded information for the full spectrum of services provided by VHSO.
• Assists facility staff with documentation requirements to completely and accurately reflect the patient care provided.
• Provides technical support in the areas of regulations and policy, coding requirements, resident supervision, reimbursement, workload, accepted nomenclature, and proper sequencing.
• Consults directly with the professional staff for clarification of conflicting or ambiguous clinical data.
• Uses expertise to search the patient record and locate documentation justifying code assignment based on an expanded knowledge of the organization and structure of the patient health record.
• Uses a variety of windows-based applications in day to day activities and duties, such as Outlook, Excel, Word, and Access.

Work Schedule: Monday-Friday, 8:00AM-4:30PM
Financial Disclosure Report: Not required

Conditions of employment

• You must be a U.S. Citizen to apply for this job
• Designated and/or random drug testing may be required
• Selective Service Registration is required for males born after 12/31/1959
• You may be required to serve a probationary period
• Subject to a background/security investigation
• Must be proficient in written and spoken English
• Selected applicants will be required to complete an online onboarding process

Qualifications

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.
• Experience and Education:
• (1)Experience. 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.
• OR,
• (2) Education. 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 experience that is paid or non-paid employment equivalent to a MRT (Coder).
• 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.
• English Language Proficiency: MRTs (Coder) must be proficient in spoken and written English as required by 38 U.S.C. § 7403(f).

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: At least one year of VA coding experience and an understanding of the VERA (Veterans Equitable Resource Allocation) Model.

Grade Determinations: In addition to the basic requirements for employment described above, the following criteria must be met when determining the grade of candidates:

Medical Records Technician (Coder) Auditor, GS-9:
Experience: One year of creditable experience equivalent to the journey grade level (GS-8) of a MRT (Coder).
Certification: Employees at this level must have a mastery level certification.

Mastery Level Certification: This is considered a higher-level health information management or coding certification and is limited to certification obtained through AHIMA or AAPC. To be acceptable for qualifications, the specific certification must represent a comprehensive competency in the occupation. Stand-alone specialty certifications do not meet the definition of mastery level certification and are not acceptable for qualifications. Certification titles may change and certifications that meet the definition of mastery level certification may be added/removed by the above certifying bodies. However, current mastery level certifications include: Certified Coding Specialist (CCS), Certified Coding Specialist - Physician-based (CCS-P),Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Outpatient Coder(COC), Certified Inpatient Coder (CIC).

NOTE: COPY OF CURRENT MASTERY LEVEL CERTIFICATION IS REQUIRED AT TIME OF APPLICATION.

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).
ii. Ability to research and solve complex questions related to coding conventions and guidelines in an accurate and timely manner.
iii. Ability to review coded data and supporting documentation to identify adherence to applicable standards, coding conventions and guidelines, and documentation requirements.
iv. Ability to format and present audit results, identify trends, and provide guidance to improve accuracy.
v. Skill in interpersonal relations and conflict resolution to deal with individuals at all organizational levels.

NOTE: KSAs MUST BE CLEARLY REFLECTED IN RESUME UNDER DESCRIPTION OF DUTIES IN ORDER TO BE FOUND QUALIFIED FOR THIS POSITION/GRADE LEVEL.

References: VA Handbook 5005/122, PART II, APPENDIX G57

This position is above the Full Performance/Journey Level, GS-9.

Physical Requirements: Work is primarily sedentary. Employee generally sits to do the work. There may be some walking, standing, or carrying of light items such as patient charts/ records, manuals or files. Employee also extracts information from computer systems which requires ability to utilize keyboards or other similar devices

How you will be evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Your application, résumé, C.V., and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment.

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.