VHA Coding Professional (Full-time, Remote)

About Us

Integrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business specializing in assisting government and commercial clients in compliance and program integrity efforts, including the prevention and detection of fraud, waste and abuse in government programs. Results are achieved through data analytics, technology solutions, audit, investigation, and medical review.

At IntegrityM, we offer a culture of opportunity, recognition, collaboration, compassion and supporting our community. We thrive off of these fundamental elements that make IntegrityM a great place to work. Our small, flexible workplace offers an exceptional quality of life and promotes corporate-driven sustainability. We deliver creative solutions that exceed goals and foster a dynamic, idea-driven environment that nurtures our employees’ professional development. Large company perks…Small company feel!

Position Overview:

We are seeking coding professionals, with experience in reviewing documentation and coding for accuracy, to conduct coding and documentation audits of Veterans Health Administration (VHA) outpatient encounters, coded by coders or providers, and claims billed to the VA through the VA Community Care Program. These audits will address accuracy of cod ed data, health record documentation issues, and include recommended remediation of specific documentation deficiencies, correction of erroneous codes, process improvement and identify educational needs. These are outpatient coding audits only, not inpatient.

Requirements

Coding Professionals:

• Shall be credentialed and have completed an accredited program for coding certification, an accredited program for health information management or health information technician. For the purpose of this engagement, a certified coding professional/reviewer is someone with one of the following active credentials listed below:
• Hold a current/active American Health Information Management Association or American Academy of Professional Coders credential. Acceptable credentials are: American Health In- formation Management Association credentials as a Registered Health Information Administrator, Registered Health Information Technician, Certified Coding Specialist, and Certified Coding Specialist– Physician, or American Academy of Professional Coders as a Certified Professional Coder or Certified Professional Coder– Hospital
• Possess formal training in anatomy and physiology, medical terminology, pathology and disease processes, pharmacology, health record format and content, reimbursement methodologies and conventions, rules, and guidelines for current classification systems (International Classification of Diseases, Common Procedural Terminology, and Healthcare Common Procedural Coding System)
• Three (3) years of experience in reviewing documentation and coding in a large hospital and outpatient health care organizations having all subspecialties and primary care with experience and training as required to hold a current/active credential listed
• Preferably, have experience performing documentation and coding reviews for VHA and have knowledge and experience with VHA coding and documentation practices, guidelines, and rules
• Knowledge of regulations that define healthcare documentation requirements, including the Joint Commission, CMS, and VHA guidelines