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Aptive Resources

Federal consulting for transformation and tech

Medical Coder - Outpatient

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours
Full-timeRemote in USA$25 - $30 /hr

About the Job

Requirements

  • An active CPC, CCS, CCS-P, RHIT, RHIA, or CPC-H credential is required.
  • At least 2 years of recent outpatient coding experience, including E/M, ancillary services, and outpatient procedures, is required.
  • Completion of an accredited coding, health information management, or health information technician program is required.
  • Formal training in anatomy and physiology, medical terminology, pathophysiology, pharmacology, and reimbursement methods is required.
  • Strong knowledge of CPT, HCPCS, NCCI edits, and modifiers is required.
  • Proficiency with an industry-standard encoder is required.
  • U.S. citizenship is required, and the candidate must be able to pass a federal background investigation (NACI) and fingerprinting.
  • A private, secure home workspace with reliable high-speed internet is required.
  • The employee must complete the VA's annual Privacy and Information Security Awareness and HIPAA training (TMS 10176 and 10203) before starting and annually thereafter.
  • The employee must follow AHIMA's Standards of Ethical Coding and VA confidentiality rules and must not use incident-to billing rules.

Responsibilities

  • Code outpatient encounters, including clinic visits, urgent care, radiology, laboratory, other ancillary services, and outpatient surgery, using ICD-10-CM, CPT-4, and HCPCS Level II.
  • Assign E/M levels according to current E/M guidelines, CPT Assistant, and Coding Clinic.
  • Apply NCCI bundling edits and add modifiers when appropriate to override them, including modifiers 25, 59, and 91.
  • Check that multiple CPT codes are not components of a larger procedure described by a single code.
  • Assign an ICD-10 diagnosis to each ancillary or diagnostic test based on the reason it was ordered.
  • Review documentation in CPRS and enter codes and data in the VistA Patient Care Encounter (PCE) package through the VA-approved encoder.
  • Determine whether an encounter is billable and flag duplicate encounters, encounters created in error, and records that do not support the assigned codes.
  • Re-review coded records when the VA questions them before billing or after a claim is denied.
  • Maintain at least 95% accuracy and meet each facility's turnaround times.

Desired Qualifications

  • Experience with VA systems, including VistA, CPRS, PCE, and Integrated Billing.
  • Experience coding outpatient surgery or ambulatory surgery.
  • Experience coding radiology or laboratory services for a hospital.

About the Company

Aptive Resources

Federal consulting for transformation and tech

Aptive Resources provides consulting services to federal government agencies to support strategic transformations, improve performance, and adopt modern technology. The company offers program and project management, strategy, analysis, integration, and implementation across Health Care Innovation, Digital and Technology Solutions, and Strategic Communications and Marketing. Aptive is a Service Disabled Veteran Owned Small Business (SDVOSB) and Woman Owned Small Business (WOSB), ISO 9001:2015 and CMMI L3 certified, with over a decade of experience on high-profile government programs. It differentiates itself through its veteran leadership, certifications, and recognition as a top workplace and government contractor. The goal is to serve as a trusted partner to federal agencies, helping them achieve strategic transformations and improved outcomes using targeted services and modern technology.

Company size
201-500
Company stage
Not listed
Total funding
Not listed
Headquarters
Alexandria, VA
Founded
2008

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