• Plans and performs audits of outpatient/inpatient medical coding and coding processes throughout BAMC to quantify coding agreement between medical record documentations and the standard ambulatory data record (SADR).
• Quantify the extent of over or under coding on patient encounters to include outpatient, ambulatory procedures, inpatient professional services rounds, inpatient consults and inpatient.
• Responsible for performing independent medical coding documentation audits, developing applicable training plans, and providing training to any BAMC employee performing documentation, coding, auditing or training functions.
• Provide BAMC leadership with a written summary of findings and recommendations for improving the accuracy of the medical record documentation and coding.
• Analyzes and evaluates the effectiveness of outpatient/inpatient medical coding processes and procedures in meeting established goals
• Conduct random medical coding documentation audits for monthly Commander's Data Quality Statement and reports findings and recommendations as required.
• Identify correct principal diagnosis and principal procedure from coded documents based on physician's medical record documentation and established sequencing rules and guidelines.

Conditions of employment

• Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation.
• A Personnel Security Investigation is required.
• Immunization screening is required. Hepatitis B immunization is required for all positions with direct patient contact. Applicants may be required to show proof of other immunizations depending on the type of position.
• Selectees will be required to sign a statement (Condition of Employment) consenting to seasonal influenza vaccinations or must provide a recognized exemption.

Qualifications

Who May Apply: US Citizens

In order to qualify, you must meet the education and/or experience requirements described below. 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; religious; spiritual; community; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document.

Basic Requirements for Health System Specialist:

Specialized Experience: One year of specialized experience which includes coding disease and injury diagnoses in accordance with regulations, determining present on admission and primary diagnosis, acuity of care and procedures; resolving inconsistencies, deficiencies, and discrepancies in medical documentation; determining acceptable diagnostic and procedural terminology/anatomy for medical nomenclature. This definition of specialized experience is typical of work performed at the second lower grade/level position in the federal service (GS-07).

OR

Education: Master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree with a major study in hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration.

OR

Combination of Education and Experience: A combination of education and experience may be used to qualify for this position as long as the computed percentage of the requirements is at least 100%. To compute the percentage of the requirements, divide your total months of experience by 12. Then divide the total number of completed graduate semester hours (or equivalent) beyond the first year (total graduate semester hours minus 18) by 18. Add the two percentages.

How you will be evaluated

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

Once the announcement has closed, a review of your application package (resume, supporting documents, and responses to the questionnaire) will be used to determine whether you meet the qualification requirements listed on this announcement.

If, after reviewing your resume and/or supporting documentation, a determination is made that you have inflated your qualifications and/or experience, you may lose consideration for this position. Please follow all instructions carefully when applying, errors or omissions may affect your eligibility.

You should list any relevant performance appraisals and incentive awards in your resume as that information may be taken into consideration during the selection process. If selected, you may be required to provide supporting documentation.

Veterans and Military Spouses will be considered along with all other candidates.