Clarification from the agency

Area of Consideration: US Citizens- Veterans with Preference will receive first consideration.

This position is located in the Health Information Management (HIM) section of the Business Operations Service at the Kansas City, VA Medical Center. The Lead Medical Records Technician (Coder) is responsible for abstracting medical record data and assigning codes using current clinical classification systems appropriate for the type of care provided. The lead coder reviews coding and assist coders in improving coding accuracy; provides coding guidance to various levels of staff to promote consistency in practice and compliance with coding rules and regulations; initiates various reports and analyzes data; and may also coordinate, assign, and monitor the workflow.

Additional duties include, but are not limited to:

• Selects and assigns codes from the current version of several coding systems to include the International Classification of Diseases-Clinical Modification (ICD-10-CM and ICD 10-PCS), Diagnostic and Statistical Manual of Mental Disorders (DSM), Current Procedural Terminology (CPT), and HCPCS.
• Adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or Evaluation and Management code.
• Performs a comprehensive review of the patient record to abstract medical, surgical, ancillary, demographic, social, and administrative data to ensure complete data capture.
• Orients and instructs new personnel and/or students from affiliated health information or medical record technology programs, at the direction of the supervisor, on unit operations, coding, abstracting, and use of an electronic health record.
• Works within a team environment; supports peers in meeting goals and deadlines; flexible and handles multiple tasks; works under pressure; and copes with frequently changing projects and deadlines.
• Conducts re-reviews of codes abstracted for patient encounters (inpatient and outpatient) identified by the VISN VERA committee to determine if based on the documentation the specific VERA coding requirements were followed; corrects coding as needed to ensure proper patient classification in the VERA program.
• Codes inpatient professional fee services for identified inpatient admissions in support of the Medical Care Cost Recovery (MCCR) program.

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

To qualify for this position, applicants must meet eligibility, basic requirements and grade determinations listed below by the closing date of this announcement, 08/26/2019.

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 or Education: (1) Experience - One year of experience that indicates knowledge of medical terminology and general understanding of the health record. Six months of the required one year of experience must have provided the knowledge, skills and abilities (KSAs) needed to perform MRT work. OR (2) Education - Two years above high school with a minimum of 12 semester hours directly related to MRT work (e.g., courses in medical terminology, anatomy & physiology, and introduction to health records). (A copy of transcript should be provided with application if applicable) OR (3) Experience/Education Combination. Equivalent combinations of experience and education are qualifying. The following educational/training substitutions are appropriate for combining education and experience: (a) Six months of experience that indicates knowledge of medical terminology and general understanding of 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 medical record techniques and procedures. Also requires six additional months of experience that indicates knowledge of medical terminology and general understanding of the health record.
• English Proficiency: In accordance with 38 U.S.C. 7402(d), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. You must be proficient in basic written and spoken English in order to perform the duties of this position.

Preferred Experience:2-3 years of inpatient and outpatient coding experienceAmerican Health Information Management Association (AHIMA) certification as CCA, CCS, CCS-P, RHIA, RHIT, or specialty coding certification.AAPC Certification as CPC, CIC, COC, CRC, or CPC-P or specialty coding certification.

Grade Determinations:GS-09, Lead Medical Record Technician (Coder): one year of creditable medical records technician experience* equivalent to the next lower grade level (GS8). This experience can be defined as analyzes medical records for pertinent diagnoses and procedures for coding, evaluates adequacy of documentation, applies advanced knowledge or medical records terminology and diseases process/pathophysiology to perform the full scope of coding, accurately performs full scope of outpatient and/or inpatient coding.In addition to the experience above, the candidate must demonstrate the following KSAs:1. Ability to work with a team to provide technical guidance, plan, organize, and coordinate activities of a medical record function in order to effectively complete job duties of assignment such as distributing workload, monitoring the status and progress of work, monitoring accuracy of work, etc.;2. Comprehensive knowledge of medical record technology theories, methods, procedures, and techniques for assigned areas; and3. Ability to communicate tactfully and effectively, both orally and in writing, in order to meet program objectives. This may include preparing reports in various formats and presenting data to various organizational levels.

*Creditable Experience(1) Knowledge of Current Medical Record Technology. To be creditable, the candidate's experience must have demonstrated the use of knowledge, skills, and abilities associated with current health information or health record technology and/or cancer registry practice and may be paid or non-paid employment.(2) Quality of Experience. Experience is only creditable if it is either directly related to the position to be filled or in a related field. Qualifying experience must also be equivalent to the next lower grade level. Experience satisfying this requirement must be active practice, which is paid/non-paid employment as a MRT.

References: VA Handbook 5005/79 Part II, Appendix G35 Medical Record Technician Qualification Standard. This can be found at your local Human Resources Office.

Physical Requirements: The work is primarily sedentary. Work may include, but is not limited to: standing up to 2 hours per day, use of both hands, use of fingers and sitting up to 8 hours per day.

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.

If applicants are interviewed for the position, performance-based interview questions will be used. For additional information regarding performance-based interviews, please review the following website on the internet: http://www.va.gov/pbi. In addition, candidates may be interviewed by a panel.

NOTE: The Professional Standards Board (a peer-review group) will review the selected candidate's education and experience and recommend the grade and salary at which the candidate will be placed. For internal selectees eligible for promotion, the board will recommend grade and HR will determine step in accordance with policy.

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.