Location
Yigo, Guam
Company Description
Entourage Consulting supports the US government. We provide comprehensive civilian staffing solutions to contract and procurement offices of US Government installations around the world. With our Headquarters in San Antonio, TX and our APAC office in Tokyo, Japan we effectively help the U.S. government with contract staff augmentation and locum services of civilian professionals. Entourage is a veteran owned fully licensed total service Provider with more than 40 years’ experience working with the US military and government.
Description of Services
Successful candidate shall be responsible for verifying and coding of the diagnosis, evaluation and management, surgeries, procedures or any other codes required for the completeness and accuracy of the medical record. Candidate verify the component parts of medical record to ensure completeness and accuracy of diagnosis, operations, and special therapeutic procedures that must conform to industry standards and MHS Coding Guidelines
General Scope of Work
• Code the primary diagnosis, co-morbidities, complications, therapeutic and diagnostic procedures, supplies, materials, injections, and drugs with the International Classification of Diseases.
• Input codes into applicable MHS coding systems.
• Primarily review medical documentation and assign codes for Outpatient encounters.
• Provide remote coding support to other AFMS MTFs via MHS computer systems.
Specific Tasks
• Solve practical problems by choosing appropriately from a variety of mathematical and statistical techniques.
• Accurately assigns diagnosis, procedure, and supply codes for the professional components of Outpatient encounters. Codes assigned include International Classification of Diseases, Clinical Modification (ICD-CM), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and modifiers.
• Reviews encounter and/or record documentation to identify inconsistencies or discrepancies that may cause inaccurate coding, medico-legal re-percussions or impacts quality patient care. Identifies any problems with legibility, abbreviations, etc., and brings to the provider’s attention.
• Examines records for proper sequence of documents, presence of authorized signatures, and sufficient data is documented that supports diagnosis, treatment administered, and results obtained.
• Works with providers to resolve documentation issues to support coding compliance. Assigns accurate codes to encounters based upon provider responses to queries and reports queries and responses IAW AFMS guidance.
• Acts as a source of reference to medical staff having questions, issues, or concerns related to coding.
• Make well-informed, effective, and timely decisions, even when data are limited or solutions produce unpleasant consequences; perceives the impact and implications of decisions.
• Receive, attend to, interpret, and respond to verbal messages and other cues such as body language in ways that are appropriate to listeners and situations.
• Work with internal and external customers to assess their needs, provide information or assistance, resolve their problems, or satisfy their expectations.
Experience/Knowledge
• Minimum of 4 years of medical coding and experience in 2 or more medical or surgical specialties within the past 8 years, OR 3 years’ outpatient coding experience within the last 6 years in a military coding environment.
• Knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT).
• Knowledge of reimbursement systems, including Prospective Payment System (PPS); Ambulatory Payment Classifications (APCs); and Resource-Based Relative Value Scale (RBRVS).
• Practical knowledge and understanding of industry nomenclature; medical and procedural terminology; anatomy and physiology; pharmacology; and disease processes.
• Practical knowledge of medical specialties; medical diagnostic and therapeutic procedures; ancillary services (includes, but is not limited to, Laboratory, Occupational Therapy, Physical Therapy, and Radiology).
• Utilize medical computer software programs to abstract, analyze, and/or evaluate clinical documentation and enter/edit diagnosis and procedure codes.
• Display courtesy, empathy, and tact, developing and maintaining effective relationships with others; effectively work with individuals who are difficult, hostile, or distressed to resolve differences; and be able to relate well to people from varied backgrounds and in different situations.
Education/Certifications:
• An associate’s degree in Health Information Management.
• At least 30 semester hours’ university/college credit that includes relevant coursework such as anatomy/physiology, medical terminology, health information management, and/or pharmacology.
• Certificate in medical coding.
The following are recognized professional certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Professional Coder (CPC); Certified Outpatient Coder (COC); Certified Coding Specialist (CCS); or Certified Coding Specialist – Physician (CCS-P). Medical Coder I coders are required to possess one of the above professional services coding certifications.
• Pass a pre-employment coding test that is provided by the AFMS MCPO, or developed by contractor management and approved by the AFMS MCPO, administered by contractor management IAW AFMS MCPO instructions, with a score of 80% or higher.