Qualifications

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.

Basic Requirements:

• United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy
• Experience and Education 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. DOE 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. DOE 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
• 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: Must have either an AHIMA or AAPC Apprentice/Associate Level Certification to include Certified Coding Associate (CCA), Certified Professional Coder-Apprentice (CPC-A) and Certified Outpatient Coding-Apprentice (COC-A)
• an AHIMA or AAPC Mastery Level Certification to include Certified Coding Specialist (CCS), Certified Coding Specialist - Physician-based (CCS-P), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC)
• or an AHIMA or ACDIS Clinical Documentation Improvement Certification to include Clinical Documentation Improvement Practitioner (CDIP) and Certified Clinical Documentation Specialist
• English Language Proficiency
• MRTs (Coder) must be proficient in spoken and written English as required by 38 U.S.C. 7403(f)
• 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: In addition to the basic requirements above, you must meet all of the follow requirements for the GS-10 Supervisory MRT (Coder) (CCU) Experience: One year of creditable experience equivalent to the next lower grade level GS-9 to include: review coding and assist MRTs (Coder) in ensuring timeliness and improving coding accuracy
• provide coding guidance to various levels of staff to promote consistency in practice and compliance with coding rules and regulations
• initiate, prepare, and maintain various reports, and analyze data
• and may also coordinate, assign, and monitor workflow
• provide input for performance evaluations and hiring
• orient and instruct new coding personnel and/or students on coding, abstracting, and use of the electronic health record and encoder software
• ensure audit findings and claim denials related to coding errors are resolved and/or daily coding rejects corrected for accurate billing and data collection
• monitor trends and/or changes in regulatory and policy requirements affecting coding practices and identify educational needs
• develop coding training materials and present a curriculum encompassing ongoing training initiatives
• provide assistance with coding inquiries from providers, MRTs (Coder), billers, and other facility staff
• Certification: A mastery level certifications through AHIMA or AAPC Certified Coding Specialist (CCS), Certified Coding Specialist - Physician-based (CCS-P), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC)
• Demonstrated Knowledge, Skills, and Abilities
• In addition to the experience above, the candidate must demonstrate all of the following KSAs: Ability to perform a full range of supervisory duties, to include recommending awards, approving leave, evaluating work, resolving staff issues, and assigning, planning, and coordinating work to ensure duties are completed in an accurate and timely fashion
• Advanced knowledge of current coding classification systems such as ICD, CPT, and HCPCS for the subspecialty being assigned (outpatient, inpatient, outpatient and inpatient combined)
• Ability to provide or coordinate staff development and training
• Leadership and managerial skills, including skill in interpersonal relations and conflict resolution to deal with employees, team leaders, and managers
• Ability to collect and analyze data, identify trends, and present results in various formats Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/
• Physical Requirements: See VA Directive and Handbook 5019, Employee Occupational Health Service.