This position is located at Crownpoint Service Unit. Division of Administrative Services, Medical Records department, Crownpoint, NM. This position works in a hybrid (paper/electronic) medical record environment, alternating between abstracting and coding pertinent outpatient medical data from the medical record into the Resource Patient Management System (RPMS) and analyzing medical data entered by the clinician into the Electronic Health Record (EHR).

Duties

Quantitative Analysis - Performs comprehensive review of the record to assure the presence of all component parts, such as; correct name, health record number, signatures and dates where required, and all reports which appear to be indicated by the treatment rendered. Qualitative Analysis - Evaluates the record for documentation, consistency, accuracy and correlation of recorded data, such as medical necessity and modifier usage. Ensures the final diagnosis as stated by the physician is valid, complete and accurately reflects the care and treatment rendered. Medico-legal Requirements - Makes the final determination that the record is complete, accurate, and reflects data to justify the diagnosis and warrant treatment without infringing on decisions concerning a physician's clinical judgment. Provides ongoing education, updates and briefs physicians, nursing staff, and health care personnel within the immediate organization or work unit, on coding updates, rules, regulations, and guidelines. Generates daily RPMS/EHR reports to review, identifies errors, inconsistencies, discrepancies and/or trends and discusses with the appropriate medical, nursing, or health care providers, and recommends appropriate modifications to RPMS/EHR entry. Assists with performing routine audits in accordance with the facility Compliance Plan and Performance Improvement, which may include findings from provider documentation trends, coding peer reviews, and reimbursement denials.

Requirements

Qualifications

To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week. MINIMUM QUALIFICATIONS: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: EXAMPLES OF SPECIALIZED EXPERIENCE FOR EACH GRADE LEVEL IS LISTED BELOW: GS-05: One (1) year of specialized experience equivalent to at least the next lower grade level, OR four (4) years of education above high school; GS-06: One (1) year of specialized experience equivalent to at least the GS-05 grade level is required. GS-07: One (1) year of specialized experience equivalent to at least the GS-06 grade level is required. EXAMPLES OF SPECIALIZED EXPERIENCE FOR THE GS-05: Experience in reviewing medical records to gather information on the reasons for admission and length of stay, referring information to quality assurance specialist for JACHO requirement. Experience in preparing correspondence and summaries of medical records in response to request. Experience in selecting and assigning a principle code along with other codes. Experience in ensuring the medical record is complete for accuracy. EXAMPLES OF SPECIALIZED EXPERIENCE FOR THE GS-06: Knowledge of coding terminology. Experience in performing chart analysis. Experience in following well-established medical record procedures, analyzing, interpreting and abstracting data from clinical documentation and/or electronic health record and assigning correct diagnostic and procedure codes. EXAMPLES OF SPECIALIZED EXPERIENCE FOR THE GS-07: Experience in evaluating the record for internal consistency and completeness. Experience in being responsible for coding the diagnoses, operations and/or procedures from the medical record and entering into the Resources and patient management system. Experience in assuring the final diagnosis and operative procedures as stated by the physician are valid and complete. Experience in making final determination that the record is complete, accurate and reflects sufficient data to justify the diagnosis. Time In Grade Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP). You must meet all qualification requirements within 30 days of the closing date of the announcement.

Education

When there is a positive education requirement, or you are using education to qualify as a substitution for experience, transcripts (unofficial) are required at the time of application to verify that you meet the educational requirement or substitution.
Only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education may be credited. Applicants can verify accreditation at the following website: https://www.ed.gov/accreditation

Foreign Education: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show that the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. For further information, visit: https://www2.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

Contacts

• Address Crownpoint Healthcare Facility PO Box 358 Crownpoint, NM 87313 US
• Name: Navajo Area IHS Human Resources
• Email: [email protected]