Medical Coding Auditor / Coding Validation Reviewer

Job Summary:

Job Summary:

Location: 100% remote (US only), supporting VA medical centers in VISN 7 Term: 12-month base period plus four 12-month option periods. Pay: 25.00/hr-30.00/hr

About the role

Aptive Resources is looking for experienced coding auditors to run external coding audits for Veterans Affairs medical centers in Georgia, Alabama, and South Carolina. You'll audit inpatient DRG, outpatient, and professional fee coding, report what you find, and teach VA coding staff and clinicians how to improve. The VA expects about 5,000 audited records a year across the Atlanta, Birmingham, Columbia, and Augusta facilities.

Primary Responsibilities:

What you'll do

• Audit coded data for accuracy and compliance, separately from the regular coding work. Each audit focuses on one area: inpatient facility (DRG), outpatient facility, inpatient professional services including surgery, or outpatient services (urgent care, clinic visits, and ambulatory surgery).
• Review up to the first 25 diagnoses and the first 25 procedures on each record, for both facility and professional services.
• Help build statistically valid samples (a 95% confidence level, and at least 10% of records) and data collection tools for each audit.
• Review each facility's HIMS policies and coding procedures before the audit starts.
• Classify errors as coding, diagnosis, modifier, documentation, or compliance errors, and back up each one with coding references.
• Write facility audit reports covering accuracy, financial impact, and areas of concern, and contribute to a network-wide report.
• Go over draft findings with the HIMS Chief, COR, and facility leaders within 7 business days of the audit, and deliver final reports within 15 business days.
• Create facility-specific training plans, and lead "train the trainer" education sessions of at least 2 hours, using real charts, for coding staff, managers, and physicians.
• Run exit conferences with Health Information Management leadership.

Minimum Qualifications:

Required qualifications

• An active RHIA, RHIT, CCS, CCS-P, CPC, or CPC-H credential.
• At least 3 years of experience as a consultant reviewing records for large tertiary care hospitals and outpatient organizations that cover all subspecialties and primary care.
• At least 3 years of education and training experience, such as teaching coders or providers.
• At least 3 years of coding experience.
• Two current client references who can speak to your audit work. These are submitted with the contract proposal.
• Proof of active credentials, plus a current resume for the proposal.
• Completion of an accredited coding, HIM, or health information technician program.
• Expertise in ICD-10-CM/PCS, CPT, HCPCS, DRG/MS-DRG, APC, E/M, and NCCI edits.
• US citizenship, and the ability to pass a federal background investigation (NACI) and fingerprinting.

Preferred qualifications

• An auditing credential such as CDIP, CPMA, or CIC, in addition to a required credential.
• Experience auditing for the VA or another federal health system.
• Strong report writing and presentation skills, including explaining findings in plain language for non-coders.

Additional requirements

• Complete the VA's annual Privacy and Information Security Awareness and HIPAA training (TMS 10176 and 10203).
• Travel to VA facilities only when the government authorizes it. Approved travel is reimbursed under federal travel regulations.

Physical Requirements:

Physical Requirements: While performing the duties of this job, the employee is regularly required to sit for extended periods, use a computer keyboard and mouse, and communicate verbally and in writing. The employee may occasionally need to stand, walk, bend, or lift up to 15 pounds. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this role.

About Aptive:

Arrow ARC supports Veterans Health Administration facilities and offices across the U.S. with health care staffing and program support via the 10-year Integrated Critical Staffing Program (ICSP). We provide staffing solutions to address critical shortages in VHA medical facilities caused by turnover, recruitment issues, seasonal needs, surges or emergencies.

 

Arrow is a certified Service-Disabled, Veteran-Owned Small Business joint venture between Artemis ARC and Aptive Resources, two award-winning companies that share an agile, mission-focused, results driven approach in the federal sector.​ Arrow provides management consulting services and specializes in working with federal government agencies like the Department of Veterans Affairs and Office of Personnel Management.​

EEO Statement:

Aptive is an equal opportunity employer. We consider all qualified applicants for employment without regard to race, color, national origin, religion, creed, sex, sexual orientation, gender identity, marital status, parental status, veteran status, age, disability, or any other protected class.

 

Veterans, members of the Reserve and National Guard, and transitioning active-duty service members are highly encouraged to apply.