Role Description We are looking for an experienced Medical Biller to join our growing team. The ideal candidate is highly detail-oriented, organized, and has previous experience working as a Medical VA or Health VA, particularly with Australian medical billing systems. You will be responsible for managing billing tasks, ensuring accurate claims processing, following up on accounts receivable, and supporting reporting functions. Key Responsibilities: - Billing & Claims Processing: Accurately prepare and submit medical billing claims to Medicare, DVA, private health funds, and patients. - Payments & Reconciliation: Reconcile payments received from multiple payers and identify any discrepancies or shortfalls for correction. - Accounts Receivable Management: Monitor outstanding claims and follow up on unpaid or denied claims to ensure timely reimbursement. - Reporting: Assist with preparation of fortnightly and quarterly reports, tracking billing performance, outstanding claims, and payment summaries. - Liaison & Communication: Coordinate with internal teams and healthcare providers for clarification of billing details and documentation. - Data Entry & Record Keeping: Maintain accurate and up-to-date patient billing records and documentation. Qualifications - Minimum 2 years experience as a Medical VA, Health VA, or in a similar healthcare billing role. - Familiarity with Australian medical billing systems (Medicare, DVA, private health insurers) preferred. - Strong understanding of medical terminology and billing processes. - Experience using billing software, Excel, and cloud-based tools. - Excellent communication skills in English, both written and verbal. - High attention to detail and strong organizational skills. - Ability to work independently and within Australian time zones. Requirements - Prior experience working with Australian medical specialists (Nice to Have). - Familiarity with medical practice management systems (e.g., Shexie, Genie, MedicalDirector, Best Practice) (Nice to Have). - Knowledge of Medicare Australia guidelines and ECLIPSE system (Nice to Have). Work Arrangement & Expectations This is a remote role that will be set up via an Employer of Record (EOR) service. To ensure alignment and transparency, successful candidates will be expected to: - Disclose any existing ongoing roles or client work. - Reflect this engagement on their LinkedIn profile.

Role Description This Lead Medical Records Technician (Coder) position is in Business Office services at the White River Junction VA Health Care System, located at the White River Junction, Vermont location. This position is a full-time at 40 hours per week. Responsibilities: - This position is eligible for Remote/Virtual work, but may require in-person attendance as per management's discretion. - Located in the Health Information Management section at the White River Junction, VT VA Medical Center. - MRTs (Coder) classify medical data from patient health records in various settings. - Analyze and abstract patients' health records and assign alpha-numeric codes for each diagnosis and procedure. - Possess expertise in: - International Classification of Diseases - Current Procedural Terminology - Healthcare Common Procedure Coding System - Provide education related to coding and documentation. - Duties include but are not limited to: - Assigning codes to documented patient care encounters (inpatient and/or outpatient). - Applying advanced knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, and procedures. - Selecting and assigning codes from current coding systems. - Adhering to accepted coding practices, guidelines, and conventions. - Monitoring regulatory and policy requirements affecting coded information. - Performing comprehensive reviews of patient health records to abstract necessary data. - Assisting facility staff with documentation requirements. - Consulting with professional staff for clarification of clinical data. - Searching patient health records to justify code assignment. Qualifications - United States Citizenship required. - May qualify based on Grandfathering Provision for current VHA employees. - One year of creditable experience equivalent to the journey grade level MRT (Coder). - Mastery level certification required for this position. Requirements - Ability to work with a team to provide technical guidance and coordinate activities. - Advanced knowledge of current coding classification systems. - Effective communication skills, both orally and in writing. - Knowledge of training methods and ability to train new coding staff. - Ability to collect and analyze data and present results. - Leadership skills, including interpersonal relations and conflict resolution. Benefits - This position is in the Excepted Service. - AFGE Bargaining Unit position. - Salary includes locality for the Rest of the US, adjusted for duty location. - Current and former Federal employees must submit copies of their most recent SF-50. Company Description For more information on this qualification standard, please visit VA Qualification Standards .

Role Description MRTs (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. These coding practitioners analyze and abstract patients' health records, and assign alpha-numeric codes for each diagnosis and procedure. - Announcement will close once 50 applicants is reached - Temporarily eligible for Remote work within 50 miles of a VA Medical Center. - May fall under the Presidential Memorandum titled "Return to In-Person Work" which will require you to go into the office if the exemption is not approved at the next review. - Selects and assigns codes from current ICD, CPT, and/or HCPCS coding systems for inpatient and outpatient encounters across the full range of VAMC health care services. - Applies advanced knowledge of medical terminology, anatomy & physiology, disease processes, procedures, and health services practices to ensure accurate code selection. - Adheres to accepted coding practices and guidelines to ensure ethical, accurate, and complete code selection across diagnoses, procedures, and E/M services. - Applies VERA program coding criteria to classify VA patients into appropriate classes based on clinical conditions and resource needs. - Assists facility staff with documentation requirements to accurately reflect patient care. - Provides technical support on regulations, coding requirements, reimbursement, and proper sequencing. - Consults directly with clinical staff to clarify conflicting or ambiguous data and reports documentation or coding errors in the electronic health record. - Uses facility systems and software to code, abstract, record, and transmit data to national VA databases. - Corrects errors or inconsistencies within established timelines and independently researches references to resolve questionable coding issues, escalating to a supervisor as needed. - May be assigned one or more of the following regular or recurring duties: - Identifies the principal diagnosis, principal procedure, and significant complications or co-morbidities for every inpatient discharge to determine the proper DRG. - Codes admission diagnoses for Community Living Center/Nursing Home Care Unit admissions using the current ICD coding system. - Re-reviews inpatient and outpatient codes identified by the VERA committee to verify compliance with VERA coding requirements, correcting codes as needed to ensure proper patient classification. - Establishes diagnosis and procedure codes for outpatient fee encounters per reimbursement regulations, linking diagnoses to procedures and determining E/M service levels. - Applies CPT coding nuances for Third Party Insurance recovery, bundles encounters appropriately, and communicates billing issues to CPAC staff. - Codes all surgical procedures using ICD and CPT guidelines and the encoder product suite, adding Anesthesia and Pathology codes for all billable cases, including creating encounters as needed. - Update codes for inpatient and Contract Nursing Home admissions for quarterly census and billable long-stay (30+ days) admissions to reflect all conditions and care through the census or billing date. - May be required to review and enter coded data from paid Community Care claims using documentation (e.g., hard-copy claims) obtained from non-VA facilities. Qualifications - U.S. Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. - Must meet ONE of the following: - One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of health records. - An associate's degree from an accredited college or university recognized by the U.S. Department of Education with a major field of study in health information technology/health information management, or a related degree with a minimum of 12 semester hours in health information technology/health information management. - Completion of an AHIMA approved coding program, or other intense coding training program of approximately one year or more that included courses in anatomy and physiology, medical terminology, basic ICD diagnostic/procedural, and basic CPT coding. - Equivalent combinations of creditable experience and education are qualifying for meeting the basic requirements. - Certification: Must have either: - Apprentice/Associate Level Certification through AHIMA or AAPC. - Mastery Level Certification through AHIMA or AAPC. - Clinical Documentation Improvement Certification through AHIMA or ACDIS. Requirements - One year of creditable experience equivalent to the next lower grade level. - Demonstrated Knowledge, Skills, and Abilities: - Skill in applying current coding classifications to a variety of inpatient and outpatient specialty care areas. - Ability to communicate with clinical staff for specific coding and documentation issues. - Ability to research and solve coding and documentation related issues. - Skill in reviewing and correcting system or processing errors. - Ability to abstract, assign, and sequence codes, including complication or comorbidity/major complication or comorbidity (CC/MCC), and POA indicators. Benefits - Competitive salary and regular salary increases. - 37-50 days of annual paid time off per year. - Up to 12 weeks of paid parental leave after 12 months of employment. - Childcare subsidy for eligible employees after 60 days of employment. - Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA. - Federal health/vision/dental/term life/long-term care insurance options.

Role Description The Coding Supervisor oversees one or more service lines of Health Information Management (HIM) coding. The Supervisor has in-depth knowledge and can interpret health record documentation to identify procedures and services for accurate code assignment. The Coding Supervisor uses the International Classification of Disease (ICD-10CM, ICD-10-PCS), Healthcare Common Procedure Coding System (HCPCS), including Physicians Current Procedural Terminology (CPT) coding systems, and other coding references to ensure accurate coding. Essential Functions of the Role - Plans, organizes, develops and manages a staff of coders. - Ensures accuracy and consistency of coded data for various records, including: - Professional fee surgical procedures - Day surgery - Emergency department - Outpatient visits - Observation - Inpatient records - Reviews records to validate diagnoses, procedures, modifiers, APC assignment, and/or DRG. - Identifies high-risk areas in coding and documentation practices. - May conduct focused quality reviews on HIM coding staff, apart from those by the BSWH HIM Audit team. - All coding must use official guidelines from: - AHA Coding Clinic - AMA CPT Assistant - AHA Coding Clinic for HCPCS - CMS publications - Provides training to coding staff and cross-trains staff as needed. - Ensures all staff record productivity daily as assigned. - Monitors staff member quality and production scores, managing or coaching them for improvement. - Takes performance improvement steps per policy when needed. - Monitors daily unbilled reports and work queues for outstanding accounts. - Adjusts staff assignments as needed and manages workload to meet daily un-coded accounts receivable. - Is a resource for resolving billing edits using the National Correct Coding Initiative and Local and National Coverage Determinations. - Facilitates billing issues with Physician Fee Schedules (PFS) and informs PFS when charges need to be moved on patient accounts. - Attends coding and reimbursement trainings and ensures staff attend when assigned. - Maintains knowledge of rules, regulations, policies, laws, and guidelines affecting coding. - Stays updated on new technology in coding and abstracting. - Serves as a resource to coding staff and other departments to answer coding and documentation related questions. - Maintains a positive relationship with physicians, nurses, clinic managers, and other contacts. Key Success Factors - Knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding area. - Knowledge of transaction code sets, HIPAA requirements and other issues impacting the coding and abstracting function. - Demonstrated expertise of the use of computer applications, group software and Correct Coding Initiatives (CCI) edits. - Proven knowledge of ICD-10 diagnosis and procedural coding and Current Procedural Terminology (CPT) procedural coding. - Ability to interpret health record documentation to identify procedures and services for accurate code assignment. - Ability to manage and perform in a team environment. - Seeks a win-win situation and builds relationships. - Outstanding communication skills to keep others well informed and encourages open dialogue. - Flexibility and adaptability while balancing requirements and regulatory and accreditation guidelines that are non-negotiables. Qualifications - EDUCATION - Bachelor's or 4 years of work experience above the minimum qualification - EXPERIENCE - 3 Years of Experience - CERTIFICATION/LICENSE/REGISTRATION - This position requires one of the following: - Cert Coding Specialist (CCS) - Cert Coding Spec Physician Bas (CCS-P) - Cert Professional Coder (CPC) - Reg Health Info Administrator (RHIA) - Reg Health Info Technician (RHIT) Benefits - Immediate eligibility for health and welfare benefits - 401(k) savings plan with dollar-for-dollar match up to 5% - Tuition Reimbursement - PTO accrual beginning Day 1 - Note: Benefits may vary based upon position type and/or level.