Role Description This position is in the Health Information Management (HIM) section at the VISN 20, Alaska, Boise, Oregon, and Washington VA Medical Center. 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. This is the journey level for this assignment. MRTs (Coder) at this level perform the full scope of inpatient and outpatient coding duties. MRTs (Coder) select and assign codes from current versions of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS classification systems to both inpatient and outpatient records. Inpatient duties consist of the performance of a comprehensive review of documentation within the health record to assign ICD-10-CM and ICD-10-PCS codes for diagnosis, complications/major complications, comorbid/major comorbid conditions, surgery, and procedures for accurate assignment of DRGs. DUTIES: - Assigns codes to documented patient care encounters (inpatient and outpatient) covering the full range of health care services provided by the VAMC. - Applies advanced knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures, and health services principles for proper code selection. - Selects and assigns codes from the current version of several coding systems including ICD, CPT, and/or HCPCS. - Adheres to accepted coding practices, guidelines, and conventions for accurate and complete coding. - Monitors regulatory and policy requirements affecting coded information for the full spectrum of services provided by the VAMC. - Performs a comprehensive review of the patient health record to abstract medical, surgical, ancillary, demographic, social, and administrative data. Work Schedule: Monday to Friday, 0730-1600 Recruitment Incentive (Sign-on Bonus): Not Authorized Permanent Change of Station (Relocation Assistance): Not Authorized Qualifications - Citizenship: Citizen of the United States. - Experience: One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding. - 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: Must have either Apprentice/Associate Level Certification or Mastery Level Certification through AHIMA or AAPC. - English Language Proficiency: Proficient in spoken and written English. Requirements - Physical Requirements: See VA Directive and Handbook 5019, Employee Occupational Health Service. - Grade Determinations: Various levels from GS-4 to GS-8 with specific experience and knowledge requirements for each grade. Benefits - Competitive salary and regular salary increases. - 37-50 days of annual paid time off per year. - Parental Leave: Up to 12 weeks of paid parental leave after 12 months of employment. - Child Care Subsidy: Eligible for a childcare subsidy after 60 days of employment. - Retirement: Traditional federal pension and federal 401K with contributions by VA. - Insurance: Federal health/vision/dental/term life/long-term care insurance options. - Telework: Not applicable, this is a remote position.

• Assigns ICD-10-CM codes, and CPT/HCPCS codes for emergency department medical record accounts • Abstracts key data elements required for billing • Reviews records for clinical pertinence and documentation • Communicates with providers for clarification of documentation • Reviews and resolves claim edits related to emergency department encounters • Assists with resolution of simple visit coding errors • Demonstrates courtesy and professionalism through interaction • Maintains patient confidentiality • Acknowledges and supports Hospitals defined goals

• Responsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings. • Adheres to all coding and compliance guidelines. • Maintains knowledge of coding/billing updates and payer specific coding guidelines. • Serves as a subject matter expert for assigned specialty. • Abstracts/codes for assigned provider(s)/division(s) based on medical record documentation. • Utilizes appropriate coding software and coding resources in order to determine correct codes. • Communicates billing related issues to assigned supervisor/manager and participates in meetings in order to improve overall billing, when applicable. • Follows departmental policies for charge corrections. • Provides feedback to providers in order to clarify and resolve coding concerns. • Resolves assigned pre-billing edits. • Assists in identifying areas that require additional training. • Mentors and assists in training other coders and new team members

Role Description As a Healthcare Billing Recovery Case Specialist I, you will work Group Healthcare (GHP) and/or Non-Group Healthcare (NGHP) Provider delinquent accounts under the CMS Medicare Secondary Payer recovery program. The medical billing specialist in this role will come with strong knowledge of: - Medical claim billing - Medical terminology and medical coding - Forms UB04 and CMS 1500 - Coordination of Benefits and Third Party Liability (COB/TPL) - Medicare Secondary Payer (MSP) claims - Procedural challenges regulations - Experience generating or auditing medical claims and billing - Ability to gather and interpret Explanation of Benefits (EOB) - Effective communication with carriers to recapture payments What You’ll Do: - Review account claim and other documentation to verify payment liability for claims that may have been paid by Medicare in error. - Leverage your knowledge and expertise in medical billing/COB/MSP to review documentation and claim billing, build the case file to determine/validate liability, evaluate and respond to defenses refuting payment liability, status the account and initiate appropriate letter correspondence. - Initiate correct action with applicable party (health insurance carrier, auto/home/worker’s comp insurance carrier, or legal representative) and documentation based upon payment option. - Update client and/or company systems with clear and accurate information such as contact and updated demographic information, notes from contact dialog and attempts, payment commitment, as well as account status updates. - Initiate applicable claim activities; follow-up and follow through accordingly to ensure documentation and activity is on-time and accurate in accordance with policies and procedures. - Support internal groups or functions with interpretation of EOB (explanation of benefits). - Arrive to work on time, work assigned schedule, and maintain regular good attendance. - Follow and comply with company, departmental and client program policies, processes and procedures. - Utilize resources to ensure compliance with client requirements, HIPAA, as well as applicable federal or state regulations. - Successfully complete, retain, apply and adhere to content in required training as assigned. - Consistently achieve or exceed established metrics and goals assigned, including but not limited to, production and quality. - Complete required processes to obtain client required clearances as well as company regular background and/or drug screening. - Demonstrate Performant core values in performance of job duties and all interactions. - Correct areas of deficiency and oversight received from quality reviews and/or management. - Work overtime as may be required. - May be required to work some Performant holidays due to client requirement. - Perform other duties as assigned. Qualifications - Minimum 6 months of medical billing experience, including Medicare. - Minimum 2 years of experience in customer service, billing reclamation or recovery, or call center role. - High School diploma or GED is required. - Knowledge and experience with medical claim billing procedures, medical terminology and medical coding. - Familiarity with information in forms UB04 and CMS 1500. - Experience with Coordination of Benefits, Third Party Liability, Medicare Secondary Payer. - Proven ability to gather and interpret Explanation of Benefits (EOB). - Ability to communicate professionally and effectively with providers, carriers, beneficiaries and other audiences regarding claims and billing payment. - Experience in handling Medicare and Medicaid claims. - Protected patients’ privacy, understands and adheres to HIPAA standards and regulations. - Remarkable interpersonal and communication skills. - Self-motivated and thrives in a fast-paced business operations department. - Proficiency using standard office technology. - Ability to apply knowledge learned in training. - Ability to follow process, procedures and regulations in the workplace. - Ability to effectively perform work independently and work cooperatively with others. - Ability to adapt quickly and transition effectively to changing circumstances. - Ability to consistently perform job responsibilities. - Ability to obtain and maintain client required clearances. - Completion of Teleworker Agreement upon hire, and adherence to the Agreement. - Possess a personality type that is ethical, friendly, hard-working and proactive. Benefits - Work from anywhere in the US! Machinify is digital-first. - Top Medical/Dental/Vision offerings. - FSA/HSA. - Tuition reimbursement. - Competitive salary, 401(k) with company match. - Additional health and wellness benefits and perks. - Flexible and trusting environment where you’ll feel empowered to do your best work. - Pay range: $19.00 - $20.00. Equal Employment Opportunity at Machinify We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law.