What are the responsibilities and job description for the Revenue Cycle/ Medical Coding SME (REMOTE) position at PacArctic LLC?
PAC
Job ID 2460078
KGS is seeking qualified candidates for our open positions, but we will only extend an offer of employment after a candidate applies through the link in our job posting. If you receive a job offer via email only and have not been interviewed by the KGS hiring manager, feel free to contact KGSrecruiting@koniag-gs.com to verify its validity.
PacArctic, LLC, a Koniag Government Services company, is seeking Revenue Cycle/Medical Coding SME to support PAC and our government customer. This position requires the candidate to be able to obtain a Public Trust. This is a Remote opportunity.
We offer competitive compensation and an extraordinary benefits package including health, dental and vision insurance, 401K with company matching, flexible spending accounts, paid holidays, three weeks paid time off, and more.
Essential Functions, Responsibilities & Duties may include, but are not limited to:
- Supports integrated Revenue Cycle solutions and services to optimize business workflows, and control cost to collect across acute, ambulatory, specialty, and inpatient venues.
Responsibilities:
- Support the client site(s) with extensive SME (Subject Matter Expert) knowledge in Cerner Millennium, 3M360, Cerner RevX, Discern reporting, Excel, and PowerBI
- Serve as a coding expert for Hospital Inpatient and Outpatient coding as well as Physician Practice coding.
- Work with various departments on documentation, coding, and auditing guidelines.
- Identify provider documentation and charge entry opportunities and coordinate for education.
- Provide training and understanding of CPT, level II HCPCS, diagnosis coding, and government payer regulations.
- Participate in optimizing workflows to support process improvement and identify additional/ongoing training needs.
- Identify trends and work in tandem with management to enhance revenue cycle performance.
- Work collaboratively with leadership to assist in developing, project management, and implementing process enhancements to enhance revenue cycle billing and coding compliance with applicable state and federal regulations.
- Assist client in exceeding the department's revenue, metrics, and objective coding goals.
- Assists with compliance audits and investigations with a primary focus on the revenue cycle by reviewing medical records for documentation compliance for CPT, HCPCS, and diagnosis codes determining that regulations are being complied with as evidenced in medical record documentation; and evaluating the appropriateness of billing and coding procedures.
- Providing consultative services to the organization’s senior leadership, providers, and staff; providing key contributions to the development of awareness, and mitigation of revenue cycle risks; and providing training and coaching to staff.
- Works autonomously under general supervision with considerable latitude for initiative and independent judgment.
- Follow changes and policies within the industry, preparing plans and goals to grow with the changes; follow company policy changes and projections that may impact.
Qualifications:
- Ability to obtain and maintain a Public Trust Clearance.
- Requires a bachelor’s degree in a clinical or healthcare-related field.
- An associate degree combined with an additional five (5) years of revenue integrity/Coding experience may be substituted for the bachelor’s degree.
- Current coding and/or HIM certifications.
- Detailed knowledge of Inpatient, outpatient, and physician office coding.
- Due to the nature of the government contract requirements and/or clearance requirements, US citizenship is required
- Intermediate experience with A/R management denial management
- Excellent problem-solving and organizational skills.
- Excellent verbal and written communication skills.
- Ability to use good judgment in highly emotional and demanding situations.
- Excellent ability to react to frequent changes in duties and volume of work.
- Maintains confidentiality of sensitive information
- Ability to provide leadership and influence others i.e. providers,
- Ability to foster effective working relationships and build consensus.
- Ability to mediate and resolve complex problems and issues.
- Understanding of HIPAA Privacy and Security regulations
Working Environment & Conditions
This job operates in a professional office environment and has a noise level of mostly low to moderate. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
This position is primarily indoors, consistent with a standard office position and has a noise level of mostly low to moderate. The incumbent is required to stand, walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; talk and hear. The workload may require the incumbent to sit for extended periods of time. The incumbent must be able to read, do simple math calculations and withstand moderate amounts of stress.
The incumbent must occasionally lift and/or move up to 25 lbs. Specific vision abilities required by the job include close vision, distance vision, color vision, depth perception, and the ability to adjust focus.
Our Equal Employment Opportunity Policy
The company is an equal opportunity employer. The company shall not discriminate against any employee or applicant because of race, color, religion, creed, sex, sexual orientation, gender, or gender identity (except where gender is a bona fide occupational qualification), national origin, age, disability, military/veteran status, marital status, genetic information, or any other factor protected by law. We are committed to equal employment opportunity in all decisions related to employment, promotion, wages, benefits and all other privileges, terms, and conditions of employment.
The company is dedicated to seeking all qualified applicants. If you require accommodation to navigate or to apply for a position on our website, please contact Heaven Wood via e-mail at accommodations@koniag-gs.com or by calling 703-488-9377 to request accommodation.
Koniag Government Services (KGS) is an Alaska Native Owned corporation supporting the values and traditions of our native communities through an agile employee and corporate culture that delivers Enterprise Solutions, Professional Services and Operational Management to Federal Government Agencies. As a wholly owned subsidiary of Koniag, we apply our proven commercial solutions to a deep knowledge of Defense and Civilian missions to provide forward leaning technical, professional, and operational solutions. KGS enables successful mission outcomes for our customers through solution-oriented business partnerships and a commitment to exceptional service delivery. We ensure long-term success with a continuous improvement approach while balancing the collective interests of our customers, employees, and native communities. For more information, please visit www.koniag-gs.com.
Equal Opportunity Employer/Veterans/Disabled. Shareholder Preference in accordance with Public Law 88-352
