CDIS Coder (Active Public Trust - On-Site Requirement) with Security Clearance

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Job description

Great Hill Solutions is currently seeking a Clinical Documentation Improvement Specialist (CDIS) to support our Defense Health client on-site in the Northern Virginia Area. This critical member of the healthcare team will support coding compliance and data quality operations as part of the Training, Auditing, and Compliance (TAC) team under the Patient Administration Department (PAD). The CDIS team will use their clinical and coding expertise to educate providers on the quality of their documentation resulting in improved patient care and better outcomes. The CDI specialist will use his/her documentation expertise to build an accurate clinical picture of the severity of illness for the patient, assess quality measures, and when necessary, query providers for clarification. Furthermore, team members will build rapport with clinical providers and provide expertise on documentation while also working with hospital coders to ensure accuracy of patient records. Responsibilities include, but are not limited to: Analyze and review medical records to ensure accurate diagnosis information according to international classification standards.
Review patient records to identify missing or potentially inaccurate coding and modify coding as appropriate.
Ensure medical coding practices that supports the diagnoses and service reported
Identifies and abstracts information from medical records (paper or electronic) for special studies and audits, internal and external.
Interacts with staff to ensure documentation is clear and supports coding assignments. Educates staff through individual or group in-services and training sessions.
Conduct internal audits and monitor coding practices and documentation deficiencies by clinics/providers in order to maximize data quality, coding timeliness, coding accuracy, and workload capture for the MTF.
Develop clinical documentation improvement training for clinics/providers in order to maximize workload capture for services provided, and to improve data quality metrics and coding compliance/timeliness statistics for the military treatment facility.
Work with Coding Compliance-Editor (CCE) software to ensure records are accurately coded. Basic Qualifications and Skills: Active Public Trust, or higher, clearance.
Ability and willingness to go on-site 100% of the time. Knowledge of The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-CM) codes, procedural coding, healthcare common procedure coding system (HCPCS)/current procedural terminology (CPT) nomenclature, medical and procedural terminology, anatomy and physiology, pharmacology, and disease processes to perform the duties described. Knowledge of reimbursement systems, including the Knowledgeable- Integrated Resourcing and Incentive System (IRIS); Prospective Payment System (PPS) and Diagnostic Related Groupings (DRG); Ambulatory Payment Classifications (APCs); and, Resource Based Relative Value Scale (RBRVS).
Knowledge of and the ability to interpret guidelines, rules and regulations developed by: Centers for Medicare & Medicaid Services (CMS), American Medical Association (AMA), American Heart Association (AHA), Military Health System (MHS) Coding Guidelines, and other applicable Federal requirements so as to provide timely and accurate information relating to coding, billing and documentation.
Excellent oral and written communication skills. The successful applicant will have excellent interpersonal skills along with the confidence to present complex medical coding issues and educational instruction to a diverse audience of medical professionals. Must be comfortable in front of high ranking, professional staff, and coding peers in order to provide training and respond to questions.
Ability to write reports, business correspondence, and procedure manuals.
Organizational, analytical, time management, statistical, and problem-solving skills.
Advanced knowledge of computers, keyboard skills, and various software programs including Microsoft (word processing, spreadsheet and database) as well as coding software programs such as the Coding Compliance Editor (CCE).
Must possess ability to pass security clearance or have a current National Agency Check with Local Agency Check and Credit Check (NACLC).
The work is primarily sedentary. Requirements may include prolonged walking, standing, sitting, or bending. Carrying or lifting of medical records may be required daily. Use of one or more computer programs and monitors simultaneously is typical and frequent. Required Education: Must have at least one of the recognized certifications: Registered Health Information Technologist (RHIT) or Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Coder Specialist (CCS), Certified Coder Specialist - Physician (CCS-P) are preferred for outpatient/ambulatory surgery medical coders as long as candidate has a minimum of three year experience in the outpatient setting (physician's office or ambulatory care centers) within the last five years. Required Experience: A minimum of three years' experience in the outpatient setting (ambulatory care centers) within the last five years is required or a minimum of two years if that experience was in a military treatment facility. Coding experience limited to making codes conform to specific payer requirements for the business office (insurance billing, accounts receivable) is not a qualifying factor. Desired Qualifications: A bachelor's degree in a clinical field is preferred.
A previous background in clinical care is preferred.
Previous experience providing documentation training to clinical providers is preferred.
Previous experience with MHS Genesis or experience in the Military Health System is preferred but not required. Diversity, Equity & Inclusion Statement: The Seneca Holdings family of companies is committed to building an inclusive work environment that encourages, supports, and celebrates the diversity of our employees. We recognize that an inclusive corporate culture improves how we support our customers and also improves the collective impact we can make in our communities. Equal Opportunity Statement: Seneca Holdings provides equal employment opportunities to all employees and applicants without regard to race, color, religion, sex/gender, sexual orientation, national origin, age, disability, marital status, genetic information and/or predisposing genetic characteristics, victim of domestic violence status, veteran status, or other protected class status. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, transfer, leave of absence, compensation and training. The Company also prohibits retaliation against any employee who exercises his or her rights under applicable anti-discrimination laws. Notwithstanding the foregoing, the Company does give hiring preference to Seneca or Native individuals. Veterans with expertise in these areas are highly encouraged to apply.

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