Medical Records Technician Coder IV-Lead

Koniag Advisory Business Solutions LLC a Koniag Government Services company is seeking a Medical Records Technician Coder IV-Lead to support KABS and our government customer in Oklahoma OKC. This position requires the candidate to be able to obtain a Public position is covered under the Service Contract Act. We offer competitive compensation and an extraordinary benefits package including health dental and vision insurance 401K with company matching paid holidays paid Vacation paid sick leave and Our Team Where Precision Integrity and Expertise Matter. Koniag Advisory Business Solutions (KABS) is seeking highly skilled self-directed Medical Records Coder IV (Lead) professionals to support a large-scale healthcare mission serving hospitals and clinics. This is an opportunity to bring your expertise to a team responsible for coding and billing more than 300000 patient visits where accuracy compliance sound judgment and accountability are this role you will help ensure the integrity of clinical documentation support compliant reimbursement and contribute to the continuity of patient care by accurately interpreting records assigning diagnostic and procedural codes and abstracting key clinical data. We are looking for seasoned professionals with a critical eye for detail deep knowledge of coding conventions and reimbursement requirements and the confidence to work independently while collaborating effectively with providers business office staff and health information management position is especially well suited for seasoned professionals who take pride in converting voluminous complex medical records into billable events maintaining high ethical standards identifying discrepancies and helping healthcare teams improve documentation quality and coding Schedule and Hybrid Conditions:This is a hybrid position based in Oklahoma City Oklahoma. We anticipate July 1 as the project kick-off date. During the first few weeks of onboarding and initial training employees are required to work on site full-time Monday through Friday 8:00 a.m. to 5:00 p.m. CT at: 701 Market Dr Oklahoma City OK working hours are generally 9:00 a.m. CT to 3:00 p.m. CT with exact start and end times determined by the Program Manager. Work hours may flex based on client on demonstrated proficiency and successful performance in all areas of responsibility employees may become eligible for telework. Telework is a temporary privilege and may be modified or rescinded at any time due to operational client business or security requirements. Employees approved for telework must:Maintain a dedicated secure home office a reliable high-speed internet within a reasonable commuting distance of Oklahoma to the office at least twice every two weeks and more often as needed for meetings or business purpose of this position is to interpret analyze and assign diagnostic and procedural codes abstract clinical information into the computer database and make determinations regarding appropriate utilization of services and medical necessity for all types of hospital and clinic records including inpatient day surgery observation emergency room and ambulatory care. The coding function provides the primary source for data and information used in healthcare promotes continuity of medical care and ensures compliance with third-party reimbursement policies regulations and accreditation guidelines. The Medical Records Coder IV (Lead) serves as a senior technical coding resource and lead-level individual contributor handling highly complex cases supporting audits and provider education mentoring junior coders and helping strengthen documentation and coding quality across the Responsibilities:Medical Record AnalysisPerforms comprehensive quantitative analysis by reviewing written dictated and electronic clinical documentation records to ensure the presence of all required components of the ambulatory or inpatient visit comprehensive qualitative analysis by evaluating the record for documentation consistency and adequacy and ensuring the final diagnosis accurately reflects the care and treatment records for compliance with established third-party reimbursement agencies special screening criteria facility policy medico-legal requirements and regulatory inconsistencies discrepancies and trends within the medical record and formulates provider queries both written and verbal for clarification and appropriate modifications to support medical necessity coding compliance and adherence to the Correct Coding Initiative facility policy and regulatory ongoing education and updates to medical staff and other healthcare providers on coding conventions rules regulations and guideline Record Coding:Applies advanced knowledge of anatomy and physiology clinical disease processes pharmacology diagnostic and procedural terminology and coding guidelines to assign codes accurately to diagnoses and encoder tools coding books internet resources and approved references to assign and sequence ICD-10-CM ICD-10-PCS CPT and HCPCS codes based on medical record that final diagnoses and procedures documented by the provider are valid and and abstracts information from the medical record to identify secondary complications and co-morbid provider documentation to ensure appropriate Evaluation and Management levels are assigned along with correct CPT and or HCPCS audits for or in conjunction with the facility compliance plan performance improvement studies medical records review processes and utilization review reports of findings education and feedback to relevant parties and may participate in committees work groups teams and discussions with medical nursing and other staff regarding coding reimbursement and documentation in development and modification of facility coding policies and with administrative staff supervisors the Administrator Site Manager and other hospital staff to resolve coding abstracting RPMS and EHR issues and recommend alternate statistics for documentation deficiencies and assists providers in the completion of incomplete and delinquent final determinations that the medico-legal requirements of the record are complete accurate and reflect sufficient data to justify the diagnosis and warranted Support:During peak workloads supports health information management operations to promote efficient incoming telephone calls and verifies patient eligibility as accurate logs of work completed and related productivity with supervisors and related staff to support efficient weekly error reports to ensure data transmission to the data error reports through validation of orphaned visits and related database audits that may include findings from provider documentation trends coding peer reviews and reimbursement reports of findings and feedback to parties with healthcare providers to maintain Superbill and Pick Lists within RPMS/ open lines of communication with Business Office staff on reimbursement issues and validity of Table Maintenance within Qualifications:High school diploma or equivalent plus 5 or more years of previous experience in medical coding or health information management; or a bachelor degree in Health Information Management and 2 or more years of progressively complex medical coding of an accredited Health Information Management or Medical Coding certification in medical coding such as CCS CPC RHIT or equivalent knowledge of ICD-10-CM/PCS CPT HCPCS and coding understanding of AHIMA and AMA coding in electronic health record systems encoder tools and health information management attention to detail analytical capability and sound independent Qualifications or ExperienceExperience working in Indian Health to mentor new staff and build cohesive working relationships with team sufficient initiative interpersonal relationship skills and social sensitivity such that he or she can relate constructively to Native American in Medicare and Medicaid rules policies best practices for hospitals and outpatient clinic billing and coding and reimbursement with HIPAA regulations and healthcare and Compliance RequirementsYou must be able to obtain and maintain a favorable Tier II background investigation determination as required by the Indian Health Service (IHS) as a condition of access to IHS facilities systems and data. Employment is contingent upon successful completion of all credentialing fingerprinting identity proofing and security processing required by IHS and any other authorized government must also be able to comply with all applicable medical privacy records confidentiality and IT security requirements governing access to patient information and federal this role you must adhere to HIPAA HITECH the Privacy Act and all IHS privacy and security policies and procedures. This includes protecting electronic and paper records using only authorized systems and approved access methods maintaining workstation and password security completing required privacy and IT security training and immediately reporting any suspected privacy breach security incident or unauthorized Requirements:Must be able to obtain and maintain a favorable Tier II background investigation determination as required by successfully complete all required fingerprinting identity proofing credentialing badge and access complete required privacy HIPAA and IT security training within required timeframes and maintain current status comply with all IHS HHS facility and company privacy confidentiality records management and cybersecurity protect PHI and other sensitive information in both paper and electronic form using required administrative technical and physical immediately report suspected privacy breaches improper disclosures security incidents malware events lost devices or unauthorized use only authorized systems accounts devices software and remote-access maintain workstation password and badge security at all be able to support periodic access reviews audits and compliance Security Requirements:If telework is approved the employee must maintain a dedicated private workspace suitable for handling confidential information and must use only authorized equipment approved connections and secure access methods. Telework may be suspended or revoked at any time if privacy security operational or contractual concerns Documentation and Pre-Employment Submission Requirements:Final candidates will be required to provide documentation and information necessary to support background investigation credentialing and access processing which may include:Government-issued identity documents for identity needed for fingerprinting and background investigation address and prior residence history as history and related verification information as certification and training documentation as other forms or supporting materials required by IHS HHS or authorized security Equal Employment Opportunity PolicyThe company is an equal opportunity employer. The company shall not discriminate against any employee or applicant because of race color religion creed ethnicity sex sexual orientation gender or gender identity (except where gender is a bona fide occupational qualification) national origin or ancestry age disability citizenship military/veteran status marital status genetic information or any other characteristic protected by applicable federal state or local law. We are committed to equal employment opportunity in all decisions related to employment promotion wages benefits and all other privileges terms and conditions of company is dedicated to seeking all qualified applicants. If you require an accommodation to navigate or apply for a position on our website please get in touch with Heaven Wood via e-mail by calling to request Government Services (KGS) is an Alaska Native Owned corporation supporting the values and traditions of our native communities through an agile employee and corporate culture that delivers Enterprise Solutions Professional Services and Operational Management to Federal Government Agencies. As a wholly owned subsidiary of Koniag we apply our proven commercial solutions to a deep knowledge of Defense and Civilian missions to provide forward leaning technical professional and operational solutions. KGS enables successful mission outcomes for our customers through solution-oriented business partnerships and a commitment to exceptional service delivery. We ensure long-term success with a continuous improvement approach while balancing the collective interests of our customers employees and native communities. For more information please Opportunity Employer/Veterans/ Preference in accordance with Public Law 88-352