NCI.

  • Virginia


  • Permanent.

  • Full-time.

VITAL FUNCTIONS BY LEVEL:

REMOTE CERTIFIED CODING EXPERT III

  • Audits medical records to guarantee compliance with the Medicare Benefit coding treatments and standards
  • Reviews insurance payments and denials and suggests billing corrections
  • Trains staff members on the coding process
  • Familiar with standard concepts, practices, and procedures within a particular field
  • Relies on limited experience and judgment to plan and accomplish goals
  • Makes use of sophisticated understanding of medical terminology, ICD-9-CM, ICD-10- CM, HCPCS Level II and CPT-4 coding along with analysis and processing of Medicare claims
  • Makes use of the Medicare standards for protection decisions and payment approaches
  • Documentation of coding decisions
  • Integrates management and communication skills to work with direct reports and peers
  • Offers training to Task order staff on medical terminology, reading medical records, coding and policy interpretation
  • Offers hearing statement, as needed
  • Completes projects in a way that fulfills or surpasses the quality guarantee goals
  • Maintains chain of custody on all documents and follows all privacy and security guidelines
  • Performs other duties as appointed by Management that contribute to Job order goals and Statement of Work guidelines and CMS regulations and regulations

Qualifications

MINIMUM REQUIREMENTS:

  • Bachelor’s Degree or comparable related experience
  • Certification/Registration as one of the following: Qualified Coding Specialist (CCS)/ Qualified Coding Specialist-Physician Board (CCS-P)/ Certified Professional Coder (CPC)
  • At least four (4) years experience in analyzing/coding of medical records
  • Need to have no adverse actions pending or taken against him/her by any State or Federal board or program

EXPERIENCE REQUIRED BY LEVEL:

  • III: 4– 9 Years

PREFERRED EDUCATION AND EXPERIENCE:

  • Experience with Medicare, especially Medicare Benefit and other federal government payment systems

PHYSICAL REQUIREMENTS:

This position needs the capability to perform the below essential functions:

  • Sitting for long periods
  • Standing for long durations
  • Ambulate throughout a workplace
  • Ambulate between several structures
  • Stoop, kneel, crouch, or crawl as needed
  • Travel by land or air transportation __ 5 _ %

It is the policy of NCI to supply equivalent chance in recruiting, working with, training, and promoting people in all task categories without regard to race, color, religion, national origin, gender, age, disability, hereditary info, veteran status, sexual orientation, gender identity, or any other secured class or classification as might be defined by federal, state, or regional laws or guidelines. In addition, we verify that all settlement, advantages, company-sponsored training, academic support, social, and recreational programs are administered without regard to race, color, faith, nationwide origin, gender, age, special needs, genetic info, veteran status, sexual orientation, or gender identity.

NCI.

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