Job Description

Overview:

J29, Inc. (J29) has been supporting commercial, State, and Federal health and human service programs since company inception in 2017 as an employee-centered healthcare management consulting company. Our team of 260 employees focuses on providing processing, review, and analysis of medical claims, records, data, and audits between areas of compliance, policy, and clinical expertise. Our team is experienced in program, payment, provider, and patient integrity as we continue to support advanced programs of policy, clinical requirements, and compliance measures at the commercial, State, and Federal levels.

J29 was founded to be an employee-centric company that prioritizes the well-being and value of its employees. Our mission is to empower our employees to do great things for the benefit of those that need it most. The J29 mission supports not only our health and human service programs, but also the philanthropy efforts of our team. We are proud to continue our support to non-profit groups with critical missions as J29 continues to grow.

Position :

J29 is looking to hire a Medical Coder to support the inpatient and/or outpatient medical coding of various medical claims or records that J29 is conducting reviews on, in partnership with the Federal government. Remotely, the Medical Coder will work in a team with a ratio of 8-10:1 in a productivity environment where cases and records will be assigned through a queue. Medical Coders will use various resources, included pre-existing knowledge, lookup tools, and other research mechanisms to ensure that claims are coded and audited properly.

Role & Responsibilities:

· Accurately assign Evaluation and Management (E&M) codes, International Classification of Diseases, Clinical Modification (ICD-CM) diagnoses, Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic) for the professional and institutional (facility) components of Day Surgery (also known as Ambulatory Procedure Visits (APVs)), including anesthesia services; Emergency Department; Observation; ambulatory or outpatient External Resource Sharing Agreement (ERSA); outpatient specialty services such as OB triage or invasive diagnostic or therapeutic procedures; and outpatient specialty encounters.

· Reviews encounter and/or record documentation to identify and resolve inconsistencies, ambiguities, or discrepancies that may cause inaccurate coding, legal repercussions or impacts quality patient care.

· Identifies any problems with legibility, abbreviations, and other discrepancies to bring them to the provider’s attention.

· Educates and provides feedback to providers and clinical staff to resolve documentation issues to support coding compliance.

· Assigns accurate codes to encounters based upon provider responses to coding queries.

· Acts as a source of reference to medical staff having questions, issues, or concerns related to coding. Responds to provider questions and provides examples of appropriate coding and documentation reference(s) to provide clarity and understanding. Collaborates with and supports medical coding auditors, trainers, and compliance specialists in providing education and feedback to providers and staff.

· Supports DHA coding compliance by performing due diligence in ethically and appropriately researching and/or interpreting existing guidance, including seeking clarification through appropriate channels.

· Upon management direction, utilizes MHS computer systems to remotely access patient records and assign codes for patient encounters in support of other MTFs.

· Achieve and maintain government assigned and expected coding productivity and accuracy standards for the position.

· Ability to research and analyze data, draw conclusions, and resolve issues; read, interpret, and apply policies, procedures, laws, and regulation related to medical coding.

· Responsible for adhering to all corporate or client policies and processes, including timelines and milestones, and working with team to ensure that there is education and comfort of such corporate (J29) policies and procedures.

· Utilize highly persuasive, direct and professional communication skills for team interaction, leadership meetings, online facilitation, group speaking, and presentations.

Experience / Expertise:

· 2-3+ years of medical coding experience in a remote environment with productivity and performance standards

· 2-3+ years of remote healthcare related experience that require work to be performed in a productivity environment (working in a queue or case management system)

· 1+ years of experience conducting medical coding lookups and research in various coding and billing software to reference ICD, CPT, and HCPCS.

· 1+ years’ experience in interpreting/coding Healthcare Common Procedure Coding System (HCPCS)/ Current Procedural Terminology (CPT) codes and coding conventions

· Prior work with Electronic Health Records (EHR), Case Management systems, and other remotely accessible medical claim and record review systems

· Specialized focus in outpatient encounter types and medical coding in outpatient environments

· Proficiency in ICD-10-CM, CPT, and HCPCS Level II coding systems

· Experienced as a proven team player, strong communication skills, excellent attention to detail, ability to receive both constructive and positive feedback in a way that promotes team work

· Candidate is/should be considered an advanced worked as it related to Microsoft Office 365 (O365) applications, such as Outlook, SharePoint, Teams, Excel, OneDrive, and Word.

Education / Certification:

· Must be a US Citizen and willing to undergo a federal background check as part of the onboarding process

· Post-high school education through a university or technical school program resulting in completion of:

o Associate’s degree or higher in Health Information Management, Healthcare Administration, or a biological science;

o A university certificate in medical coding;

o Successful completion of a training course beyond apprentice level 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.

· Certification relevant to the role in an accredited certifying agency, such as one within:

o Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist – Physician (CCS-P)

And:

o Certified Outpatient Coder (COC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Evaluation and Management Coder (CEMC), National Alliance of Medical Auditing Specialists’ (NAMAS) Certified Evaluation and Management Auditor (CEMA)

J29, Inc. is committed to hiring and retaining a diverse workforce. We are proud to be an Equal Opportunity/Affirmative Action Employer, making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class. J29, Inc. is a proud Veteran friendly employer.

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