Medical Records Tech (Coder-Inpatient)

Veterans Health Administration; United States; Remoto; USD 58.000 - 86.000; Tempo pieno

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Remote work

Descrizione del lavoro

Veterans Health Administration is seeking an MRT (Coder-Intpatient) in the Health Information Management (HIM) section at the Dayton VA Medical Center. The role involves classifying medical data from patient records and coding diagnoses and procedures for inpatient settings.

The position is remote anywhere in the U.S. with telework options; standard schedule Monday through Friday, 8:00 am to 4:30 pm Eastern Time, with competitive pay range of $57,963 to $85,608 per year.

Descrizione del lavoro

• Department: Department of Veterans Affairs
• Location: Anywhere in the U.S. (remote job)

This position is located in the Health Information Management (HIM) section at the Dayton VA Medical Center. MRTs (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. This position is MRT (Coder-Intpatient).

Key Responsibilities

Major duties include but are not limited to: Analyze and abstract patients' health records and assign alpha numeric codes for each diagnosis and procedure. Independently review and abstract clinical data from the record for documentation of diagnoses and procedures to ensure it is adequate and appropriate to support the assigned codes.

Code all complicated and complex medical/specialty diseases processes, patient injuries, and all medical procedures in a wide range of inpatient settings and specialties. Abstract, assign, and sequence codes into encoder software to obtain correct diagnosis related groups (DRG), support medical necessity, resolve encoder edits, and ensure codes accurately reflect services rendered.

Review provider health record documentation to ensure that it supports diagnostic and procedural codes assigned and is consistent with required medical coding nomenclature. Enter and correct information that has been rejected, when necessary. Ensure audit findings have been corrected and refiled. Assigns codes to documented patient care encounters (inpatient facility and/or professional services) covering the full range of health care services provided by the VAMC.

Adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or E/M code to ensure ethical, accurate, and complete coding. Monitors ever-changing regulatory and policy requirements affecting coded information for the full spectrum of services provided by the VA Medical Center.

Performs a comprehensive review of the patient health record to abstract medical, surgical, ancillary, demographic, social, and administrative data to ensure complete data capture. Assists facility staff with documentation requirements to completely and accurately reflect the patient care provided; provides technical support in the areas of regulations and policy, coding requirements, resident supervision, reimbursement, workload, accepted nomenclature, and proper sequencing.

Insures provider documentation is complete and supports the diagnoses and procedures coded. Reports incorrect documentation or codes in the electronic patient health record. Expertly searches the patient health record to find documentation justifying code assignment based on an expanded knowledge of the organization and structure of the patient record. Identifies the principal diagnosis and principal procedure (when applicable) for every inpatient discharge.

Other duties as assigned. Total Rewards of a Allied Health Professional Work Schedule: Monday - Friday, 8:00 am to 4:30 pm (Eastern Time Zone) Recruitment Incentive (Sign-on Bonus): Not authorized Permanent Change of Station (Relocation Assistance): Not authorized Pay: Competitive salary and regular salary increases.

When setting pay, a higher step rate of the appropriate grade may be determined after consideration of higher or unique qualifications or special needs of the VA (Above Minimum Rate of the Grade). Paid Time Off: 37-50 days of annual paid time offer per year (13-26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year) Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience.

Parental Leave: After 12 months of employment, up to 12 weeks of paid parental leave in connection with the birth, adoption, or foster care placement of a child. Child Care Subsidy: After 60 days of employment, full time employees with a total family income below $144,000 may be eligible for a childcare subsidy up to 25% of total eligible childcare costs for eligible children up to the monthly maximum of $416.66.

Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA. Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Telework: This position is designated as remote. Remote work is defined as full-time employment conducted outside of a VA facility or in VA-leased spaces.

The option for remote work will be assessed continuously, and the selected individual may need to return to a VA office if required. Applicants must live within 50 miles of one of our facilities as they may be subject to the RTO order. Virtual: This is not a virtual position. Functional Statement #: 91548-A Permanent Change of Station (PCS): Not authorized PCS Appraised Value Offer (AVO): Not authorized

Requirements & Education

Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education.

For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

Which agency is hiring for this position?

This position is with Veterans Health Administration, Department of Veterans Affairs.

What is the salary for this position?

The posted pay range is $57963 – $85608/yr.

Is this position remote or telework eligible?

Yes, this position is fully remote.

What is the application deadline?

Applications close on 2026-11-18.

Who is eligible to apply?

This position is open under the 'Public' hiring path.