• Utilize various hospital/physician systems to verify patient, billing and claim information for accuracy • Perform compliant primary/secondary, tertiary and rebill billing functions which can include electronic, paper and portal submission to payers. • Edit claims to meet and satisfy billing compliance guidelines for electronic and hardcopy submission. • Respond timely to emails and telephone messages as appropriate. • Communicate issues to management, including payer, system or escalated account issues. • Participate and attend meetings as requested, training seminars and in-services to develop job knowledge. • Serve and protect the hospital community by adhering to professional standards, hospital policies and procedures, federal, state, and local requirements, and JCAHO standards. • Enhance billing department and hospital reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments. • Update patient demographics/insurance information in appropriate systems - Monitor claims for missing information, authorization, and control numbers (ICN//DCN) • Follow guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems. • Secure needed medical documentation required or requested by third party insurance carriers. • Maintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure. • Perform other related duties as required.

Role Description The Southern Arizona Veterans Affairs Medical Center in Tucson, Arizona is seeking a dynamic Medical Records Technician (Coder-Inpatient) to join our Health Information Management (HIM) team! MRT (Coder-Inpatient) will analyze and abstract patients' health records and assign alpha-numeric codes for each diagnosis and procedure. - Select and assign codes from current versions of ICD-10-CM, ICD-10-PCS, and/or CPT and HCPCS classification systems for inpatient facility and/or professional services. - Perform a comprehensive review of documentation within the health record to assign ICD codes for diagnosis, complications/major complications, comorbid/major comorbid conditions, surgery, and procedures for accurate assignment of diagnosis related groups (DRG), and/or assigning CPT/HCPCS codes for inpatient professional services. - Code all complicated and complex medical/specialty diseases processes, patient injuries, and all medical procedures in a wide range of inpatient settings and specialties. - Directly consult with the clinical staff for clarification of conflicting, incomplete, or ambiguous clinical data in the health record. - Abstract, assign, and sequence codes into encoder software to obtain correct DRG, support medical necessity, resolve encoder edits, and ensure codes accurately reflect services rendered. Work Schedule: Monday-Friday 7:00 am -3:30 pm Telework: This position is telework eligible but may be required to return to the office permanently at a later date. Virtual: This is not a virtual position. 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. - 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. Requirements - Certification: 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. - Minimum experience of one year of inpatient facility coding. - Ability to analyze the health record to identify all pertinent diagnoses and procedures for inpatient coding and to evaluate the adequacy of the documentation. - Ability to accurately perform the full scope of inpatient coding, including inpatient discharges, surgical cases, diagnostic studies and procedures, and inpatient professional services. - Skill in interpreting and adapting health information guidelines that are not completely applicable to the work or have gaps in specificity. Benefits - The majority of work will be sedentary, but standing, bending may be necessary.

• Monitoring and working work queues/dashboard for assigned providers and specialties, to include coding, researching, and trending of coding/billing behaviors • Code all documented professional services provided in both clinic and other facilities • Applies CPT-4, ICD-10-CM, HCPCS and modifiers following coding guidelines • Adheres to official coding guidelines, AMA and CMS • Expert in reviewing assigned providers/specialty areas • Ensures coded services, provider charges and medical record documentation meet appropriate guidelines and standards • Keeps abreast of coding guidelines and reimbursement reporting requirements • Illustrate knowledge of healthcare industry in areas of coding, revenue cycle, claims and state specific insurance/laws • Ensure timely charge review/processing of daily submissions • Monthly review of reports to identify and abstract any missed charges in assigned specialties • Works collaboratively with Team to ensure monthly goals are met • Responsible for creating/updating reference tools for assigned specialties as needed (tip sheets/coding guidelines, etc.) • Utilize appropriate application/methods to ensure all documented professional services are submitted timely • Ability to identify/trend/summarize potential compliance, coding, billing concerns and bring forth a potential resolution • Other duties as assigned

• Perform remote coding on all inpatient admissions and outpatient visits assigned by VA Portland Health Care System (VAPORHCS). • Provide all labor, equipment, and supplies for coding medical records from VA Portland HCS. • Access VA Portland’s VistA/CPRS system to read and code medical records identified by Portland, and enter codes into the approved coding application. • Perform the services following coding guidelines and appropriate references. • Create reports, monitor coders, and make recommendations. • Code all cases no later than 7 days after receipt (outpatient) or 7 days after discharge date (inpatient). • Priority cases that are assigned will be required to be coded within one day of receipt.