Role Description This position is located in the Health Administration Service (HAS), Health Information Management (HIM) section at the VA Greater Los Angeles Healthcare System. MRTs (Coder) are skilled in classifying medical data from patient health records. PLEASE READ THE DUTIES SECTION OF THIS ANNOUNCEMENT FOR FURTHER INFORMATION ON REMOTE WORK STATUS. - This position is designated as remote. Remote work is defined as full-time employment conducted outside of a VA facility or in VA-leased spaces. - The option for remote work will be assessed continuously, and the selected individual may need to return to a VA office if required. - The VA will categorically exempt military spouses authorized to engage in remote work and spouses of U.S. Foreign Service members from Agency plans to return all eligible employees to in-person work instead of remote or telework arrangements. - Any selected candidate must live within 50 miles of a VA Medical Center. - Applying comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures. - Selecting/assigning codes from the current version of several coding systems to include current versions of the International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and/or Healthcare Common Procedure Coding System (HCPCS). - Adhering to accepted coding practices, guidelines, and conventions. - Applying codes based on guidelines specific to certain diagnoses, procedures, and other criteria. - Monitoring ever-changing regulatory and policy requirements affecting coded information for the full spectrum of services provided by the VAMC. - Timely compliance with coding changes is crucial to the accuracy of the facility database as well as all cost recovery programs. - Performing a comprehensive review of the patient health record to abstract medical, surgical, ancillary, demographic, social, and administrative data to ensure complete data capture. - Developing performance standards and conducting performance evaluations for subordinate staff. - Keeping employees informed of management goals and objectives and higher-level supervisors informed of employee participation and concerns. - Scheduling the sequence of work and operations on a weekly, monthly, and quarterly basis. - Assuring even workflow and distribution, expeditious handling of priorities, and meeting of deadlines. - Revising schedules/assignments to meet changes in workload considering peak loads, availability of manpower, and time limits. - Making changes in organization and assignment of duties to provide improvements, promote job satisfaction, and increase productivity. - Preparing workload and production reports; reports on operations and problems encountered. - Presenting proposed requests for resource needs based on past experience, anticipated staffing, equipment, and space. - Formulating and issuing written instructions and procedures and special instructions for non-routine or complex assignments or to clarify published guides. Work Schedule: Monday - Friday 7:30 a.m. - 4:00 p.m. Telework: Not Available Virtual: This is a virtual position. Functional Statement #: 000000 Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Qualifications - Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. - United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. - Experience: One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of health records. - Education: 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. - Certification: 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. - Experience/Education Combination: Equivalent combinations of creditable experience and education are qualifying for meeting the basic requirements. Requirements - Persons hired or reassigned to MRT (Coder) positions in the GS-0675 series in VHA 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. - Mastery level certification is required for all positions above the journey level; however, for clinical documentation improvement specialist assignments, a clinical documentation improvement certification may be substituted for a mastery level certification. - May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation. Benefits - The full performance level of this vacancy is GS-10. - The actual grade at which an applicant may be selected for this vacancy is in the range of GS-10. Physical Requirements This position is primarily sedentary.

• Assigns appropriate ICD and CPT codes for reimbursement and statistical purposes. • Follows ICD, CPT, CMS, and other regulatory coding guidelines. • Abstracts clinical information from medical records for complete and accurate statistical documentation. • Reviews and interprets medical documentation to accurately assign ICD and CPT codes for facility or professional reimbursement and statistical purposes. • Abstracts information into computer for reimbursement and statistical purposes. • Researches and stays current with trends in healthcare coding and compliance. • Keeps department manager up to date with any coding or documentation issues. • Works as a team with physicians, coding staff and other hospital personnel to ensure proper and accurate code assignment and continuous quality improvement. • Responsible for assisting with coding claim edits and reviewing claim denials for correction. • Reports to work in a timely manner and adheres to attendance policies. • Conscientious of scheduling time off in advance so as not to interfere dramatically with coding turnaround times. • Performs all Other duties as assigned.

Role Description The Medical Coding Specialist II is responsible for performing accurate and compliant coding activities while supporting revenue cycle operations across multiple specialties. This role requires a comprehensive understanding of the entire billing cycle, including: - Medical terminology - Coding principles - Charge entry - Insurance adjudication - Contractual agreements - Payment posting - Statements - Collections The ideal candidate demonstrates strong analytical skills, coding accuracy, and attention to detail while ensuring compliance with regulatory guidelines and organizational standards. This role collaborates closely with: - Providers - Clinical teams - Revenue cycle partners to support operational excellence, optimize reimbursement, and maintain coding integrity across healthcare services. Qualifications - High School Diploma or Equivalent (Required) - Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) (Required) - Specialty Coding Certification(s) (Preferred) Requirements - Minimum 5 years of professional medical coding experience required - Comprehensive understanding of the entire revenue cycle required - Multi-specialty coding experience preferred - Specialty coding experience and certifications preferred - Experience with Epic, GECB, or Allscripts preferred - Demonstrated knowledge of coding regulations, payer guidelines, and coding compliance standards preferred Benefits - Medical, Dental, Vision plans - Adoption, Fertility and Surrogacy Reimbursement up to $10,000 - Paid Time Off and Sick Leave - Paid Parental & Family Caregiver Leave - Emergency Backup Care - Long-Term, Short-Term Disability, and Critical Illness plans - Life Insurance - 401k/403B with Employer Match - Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education - Student Debt Pay Down – $10,000 - Reimbursement for certifications and free access to complete CEUs and professional development - Pet Insurance - Legal Resources Plan - Colleagues may have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met

Role Description Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. - Communicates with insurance companies about coding errors and disputes (physician billing). - Abstracts pertinent data points for billing and quality reviews. - Communicates with various departments as needed to ensure accuracy of patient data. - Conducts audits and/or coding reviews with various health care professionals to ensure all documentation is accurate (physician billing). - May assign and sequence basic CPT (Current Procedural Terminology) procedure codes (non-complex), and modifiers based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP) guidance in encoder software and/or department coding policies and procedures. - Using encoder, reviews Ambulatory Payment Classifications (APC) and Enhanced Ambulatory Patient Groups (EAPG) assignments. - Reviews Local Coverage Determination (LCD) edits and guidance for codes meeting medical necessity. - Researches medical record for any additional diagnoses documented to meet medical necessity. - Reviews and validates the accuracy of data in the Admission, Discharge Transfer (ADT) fields following HIM coding procedures and processes. - Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and modifier code assignments. - For hospital coding, reviews medical record documentation (i.e., provider orders); may code outpatient diagnostic and therapeutic encounters requiring minimal procedural coding. - For physician billing, collaborates with billing department to ensure all bills are satisfied. - For hospital, routes to billing charge entry errors and/or account edits preventing completion of coding and/or billing. - Makes appropriate coding corrections, when advised, and follows procedure to notify billing. - Enhances and maintains coding knowledge and skills. - Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. - Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. - Submits daily productivity report to HIM manager by defined deadline. - Meets and maintains HIM coding quality and productivity standards. - Attends internal and external educational meetings and seminars to maintain certification and continuing education requirements. Qualifications - High School Diploma or Equivalent (Required) - Certified Coding Associate (CCA) - American Health Information Management Association (AHIMA) - Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) - Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA) - Registered Health Information Technician (RHIT) - State of Florida (FL) - Registered Health Information Technician (RHIT AHIMA) - American Health Information Management Association (AHIMA) Requirements - For HIM coder, one (1) year hospital-based outpatient coding experience. - For Physician Billing Coder, one (1) year diagnostic/procedural office coding experience with surgical coding experience or six (6) months working within the Memorial Health System. - Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS) or Certified Coding Associate (CCA). - For Physician Billing: Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Risk Adjustment Coder (CRC) by AAPC, or Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCSP) by AHIMA. - For Hospital Billing: Certified Coding Specialist (CCS), Certified Coding Associate (CCA) or Certified Professional Coder (CPC). Company Description