Job Summary

We are seeking experienced Medical Coders / HIMS Coding Specialists to provide medical coding, coding validation, auditing, and clinical documentation review services supporting Veterans Health Administration (VHA) VISN 7 facilities.

The selected candidate will be responsible for accurately reviewing medical records and assigning appropriate diagnosis and procedure codes for inpatient, outpatient, professional fee, surgical, and specialty healthcare services.

Key Responsibilities

• Perform accurate medical coding for inpatient and outpatient healthcare encounters.
• Review medical records and assign appropriate ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II codes.
• Perform coding validation and quality audits to ensure coding accuracy and completeness.
• Review clinical documentation and identify documentation deficiencies and coding discrepancies.
• Support Clinical Documentation Improvement (CDI) activities.
• Identify potential coding, reimbursement, compliance, and documentation risks.
• Review coding information within systems such as VistA, PCE, PTF, Integrated Billing (IB), and related healthcare applications.
• Perform professional fee, surgery, specialty, and other applicable medical coding.
• Ensure all assigned encounters are coded accurately, including non-billable encounters.
• Maintain compliance with VA/VHA policies, Federal regulations, and nationally recognized coding guidelines.
• Participate in coding education and provide feedback regarding documentation and coding quality.
• Prepare coding audit reports and quality assurance documentation.
• Maintain confidentiality and security of Veteran health information.

Required Qualifications

• Experience in medical coding, HIMS, coding auditing, or healthcare revenue cycle.
• Strong knowledge of: ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II.
• Experience with inpatient and/or outpatient medical coding.
• Knowledge of medical terminology, anatomy, physiology, and clinical documentation.
• Experience performing coding audits and validation reviews.
• Strong understanding of healthcare coding compliance and documentation requirements.
• Ability to work independently in a remote environment.
• Strong attention to detail and analytical skills.
• Excellent written and verbal communication skills.

Preferred Qualifications

• Experience supporting VA/VHA, Veterans Health Administration, or Federal healthcare facilities.
• Experience with VistA, PCE, PTF, Integrated Billing (IB), or similar healthcare information systems.
• Experience with Clinical Documentation Improvement (CDI).
• Experience in coding quality assurance and auditing.
• CPC, CCS, CCS-P, CCA, or other recognized coding certification preferred.
• Experience with inpatient, outpatient, professional fee, surgery, and specialty coding.

Core Skills

Medical Coding | HIMS | ICD-10-CM | ICD-10-PCS | CPT | HCPCS | Medical Auditing | Coding Validation | Clinical Documentation Review | CDI | VistA | PCE | PTF | Integrated Billing | Healthcare Compliance | Quality Assurance

Work Environment

100% Remote

Work will be performed remotely and not at the contractor's physical facility.

Candidate must be able to meet all applicable security, confidentiality, and Federal healthcare requirements.

This is a remote position.