The Lead Medical Records Technician (Coder) position is located in the Health Information Management (HIM) section of the Business Operations Service (BOS) at the Kansas City, VA Medical Center (KCVAMC). Incumbent reviews coding and assists coders in improving coding accuracy; provides coding guidance to various levels of staff to promote consistency in practice and compliance with coding rules and regulations; and initiates various reports and analyzes data.

Duties

Kansas City VA Medical Center is committed to Diversity and Inclusion. Together, we strive to create and maintain a working and learning environment that promotes professional growth and teamwork. We offer an inclusive, equitable, and welcoming environment where we celebrate our individual differences and unite as a team toward a common goal of providing outstanding service to our Nation's Veterans. Major duties include, but are not limited to: Selects and assigns codes from the current version of several coding systems to include the International Classification of Diseases-Clinical Modification (ICD-10-CM and ICD 10-PCS), Diagnostic and Statistical Manual of Mental Disorders (DSM), Current Procedural Terminology (CPT), and HCPCS. Adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or Evaluation and Management code. Performs a comprehensive review of the patient record to abstract medical, surgical, ancillary, demographic, social, and administrative data to ensure complete data capture. Orients and instructs new personnel and/or students from affiliated health information or medical record technology programs, at the direction of the supervisor, on unit operations, coding, abstracting, and use of an electronic health record. Works within a team environment; supports peers in meeting goals and deadlines; flexible and handles multiple tasks; works under pressure; and copes with frequently changing projects and deadlines. Codes inpatient professional fee services for identified inpatient admissions in support of the Medical Care Cost Recovery (MCCR) program. Work Schedule: Monday- Friday, 7am-3:30pm or 8am-4:30pm Telework: Available Virtual: This is not a virtual position. Functional Statement #: 000000 Financial Disclosure Report: Not required

Requirements

Qualifications

To qualify for this position, applicants must meet both basic requirements and the grade determination by the closing date of this announcement, 02/07/2024. Basic Education and/or Experience Requirements: Experience. One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of a health records; OR 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 (e.g., courses in medical terminology, anatomy and physiology, medical coding, and introduction to health records); OR 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. The training program must have led to eligibility for coding certification/certification examination, and the sponsoring academic institution must have been accredited by a national U.S. Department of Education accreditor, or comparable international accrediting authority at the time the program was completed; OR Experience/Education Combination. Equivalent combinations of creditable experience and education are qualifying for meeting the basic requirements. The following educational/training substitutions are appropriate for combining education and creditable experience: Six months of creditable experience that indicates knowledge of medical terminology, general understanding of medical coding and the health record, and one year above high school, with a minimum of 6 semester hours of health information technology courses; OR Successful completion of a course for medical technicians, hospital corpsmen, medical service specialists, or hospital training obtained in a training program given by the Armed Forces or the U.S. Maritime Service, under close medical and professional supervision, may be substituted on a month-for-month basis for up to six months of experience provided the training program included courses in anatomy, physiology, and health record techniques and procedures. Also, requires six additional months of creditable experience that is paid or non-paid employment equivalent to a MRT (Coder). Certification. Persons hired or reassigned to MRT (Coder) positions in the GS-0675 series must have Mastery Level Certification through AHIMA or AAPC.* English Language Proficiency. MRTs (Coder) must be proficient in spoken and written English as required by 38 U.S.C. § 7403(f). United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grade Determinations: Lead Medical Records Technician (Coder), GS-9 Candidates must meet the basic requirements above and all of the grade determinations below: Experience. One year of creditable experience equivalent to the journey grade level MRT (Coder), GS-8. This experience is described as: independently selects and assigns codes from current versions of ICD CM, PCS, CPT, and HCPCS classification systems to both inpatient and outpatient records; reviews and abstracts clinical data from the record for documentation of diagnoses and procedures; consults with clinical staff for clarification of conflicting, incomplete, or ambiguous clinical data in the health record. Certification. Employees at this level must have Mastery Level Certification through AHIMA or AAPC. Demonstrated Knowledge, Skills, and Abilities. In addition to the experience above, the candidate must demonstrate all of the following KSAs: i. Ability to work with a team to provide technical guidance, plan, organize, and coordinate activities in order to effectively complete job duties of assignment, such as distributing workload, monitoring the status and progress of work, monitoring accuracy of work, etc. ii. Advanced knowledge of current coding classification systems for the sub-specialty being assigned (outpatient, inpatient, outpatient and inpatient combined) and the ability to research and solve complex questions related to coding conventions and guidelines in an accurate and timely manner. iii. Ability to effectively communicate, both orally and in writing, in order to meet program objectives. iv. Knowledge of training methods and the ability to provide training to new coding staff. v. Ability to collect and analyze data and present results in various formats, which may include presenting reports to various organizational levels. vi. Leadership skills, including interpersonal relations and conflict resolution between employees, managers, and clinical staff. Preferred Experience: 3-4 years of inpatient and outpatient coding experience. References: VA Handbook 5005/122, PART II, APPENDIX G57 dated December 10, 2019.The full performance level of this vacancy is GS-9. The actual grade at which an applicant may be selected for this vacancy is GS-9. Physical Requirements: The work is primarily sedentary. Work may include, but is not limited to: standing 2 hours per day, use of both hands, use of fingers and sitting up to 8 hours per day.

Education

IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

Contacts

• Address Kansas City VA Medical Center 4801 Linwood Boulevard Kansas City, MO 64128 US
• Name: Patricia Arrieche
• Phone: 316-469-0916
• Email: [email protected]