Auditor/Trainer

Req No
2019-5525
Category
Production Coding
Type
Contract to Permanent (Full Time)

Overview

Perform on-site, full-time auditing and training services as a mandated BUMED requirement.  All training will focus on improving documentation to support accurate coding of the medical encounter.

Responsibilities

  • The contractor shall develop training that is specific to the clinical services provided by the MTF and will incorporate standardized BUMED training guidance to facilitate evolving requirements (i.e. ICD-10 implementation).   
  • The contractor shall work in conjunction with the MTF personnel and the AHLTA Sustainment trainers in the performance of these services.

 

  • ICD-10  and CPT codes and conventions
  • Inpatient and outpatient documentation
  • RVU/RWP documentation and coding
  • Residency specific issues (as applicable)
  • Use of HCPCS and CPT codes
  • Inpatient and outpatient documentation
  • Inpatient and outpatient query form process
  • MS-DRG validation
  • Changes in industry coding conventions and nomenclature
    • ICD-10 preparation
    • Industry coding classification updates

 

  • The Contractor shall ensure the training materials are continuously updated to relay the most current and relevant information.  The curriculum shall include specific information and examples relevant to the clinical area for which the training is provided. 
  • The Contractor shall NOT include instruction on how to use the Government systems such as AHLTA, CHCS, or CCE in their curriculum
  • The Contract employee will document system related issues brought up during training in their report of audit findings.
  • The Contract employee shall incorporate audit findings and feedback from providers (to include residents and interns), clinical staff and coders into their training.
  • The Contractor shall use a variety of methods to provide training, which may include, but are not limited to, group training, one-on-one training, webinars, web based training, power point presentations, VTC and instructional videos. 
  • The Contractor shall train in the most effective manner.
  • The Contractor shall coordinate training with the MTF point of contact identified in the task order, identifying any specific individuals requiring focused attention. 
  • The Contractor shall identify any teaching tools/equipment required for training at least two weeks in advance of training. 
  • The Contractor shall provide instructions to residents in MTFs with graduate medical education (GME) programs.  The frequency and method of training shall be coordinated with the Program Director of each residency via the MTF COR.  GME programs exist at the MTFs listed below.

 

  • Naval Medical Center San Diego
  • Naval Medical Center Portsmouth
  • National Naval Medical Center Bethesda
  • Naval Hospitals Bremerton, Camp Pendleton, Jacksonville, Pensacola, and Camp Lejeune (Family Practice GME)
  • Navy Medicine East: 1 FTE provides auditing and training services
  • The Contractor shall work with the AHLTA Sustainment Trainer to help the healthcare providers understand the most efficient process for entering information into the system.  The Government is responsible for ensuring that the AHLTA sustainment trainer is available when the Contract employee is on-site.

Additional Functions:

  • Keep up to date on coding rules and standards
  • Analyze data; read, interpret, and apply policies, procedures, laws, and regulations;
  • Read and interpret medical procedures and terminology;
  • Prepare reports and related documents;
  • Maintain working relationships with personnel;
  • Maintains and complies with policies and procedures for confidentiality of all patient records.
  • Demonstrates knowledge of security of systems by not sharing computer logons.
  • Consistently supports the compliance and principles of responsibility by maintaining confidentiality, protecting the assets of the organization, acting with integrity, reporting observed fraud and abuse and complying with applicable state, federal and local laws and program policies and procedures.   

Qualifications

Qualifications:

Education:

High School Diploma or G.E.D.

 

Certification or License:

Possess and maintain one of the professional coding certifications issued by AHIMA or AAPC.

 

Experience:

Qualified applicants will possess and maintain one of the certifications specified in this Section for auditing personnel and 1 year of auditing experience within the preceding 2 years and possess 1 year of HIM experience in process improvement, data quality improvement, or documentation improvement.  

 

Knowledge, Skills and Abilities:

  • ICD-10-CM, and CPT coding guidelines; medical terminology; Medicare reimbursement guidelines;
  • Prior Military Health System experience preferred.
  • Strong working knowledge of ICD-9-CM coding rules and standards
  • Strong understanding of medical terminology and anatomy
  • Basic familiarity with performing PC-based data entry
  • Ability to review and process information to determine conclusions, actions or compliance with applicable laws, rules or regulations.
  • Substantive knowledge of and ability to use correct grammar, vocabulary, spelling, proofreading and office terminology to compose and/or proofread correspondence, reports and materials.
  • Skill in communicating effectively in the English language both orally and in writing
  • Excellent attention to detail, strong computer skills, and experience working with physicians a must.
  • Knowledge of legal, regulatory and policy compliance issues related to medical coding and documentation and billing procedures.
  • Knowledge of current and developing issues and trends in medical coding.
  • Ability to analyze, problem-solve, and work independently effectively.
  • Strong communication and interpersonal skills.
  • Ability to provide guidance and training to professional and technical staff in area of expertise.

Peak Health Solutions, an AMN Healthcare company, is an EEO/AA/Disability/Protected Veteran Employer We encourage minority and female applicants to apply

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