Lead VHA Contract Coder

This is a fully remote position, open to applicants in Virginia.

📋 Description

• Execute outpatient and/or inpatient facility coding which includes ICD-10-CM, ICD-10-PCS, CPT/HCPCS, DRG, and E&M for all encounters assigned by VAPORHCS.

• Access and assess health record documentation within the VA's VistA/CPRS system; input codes into the designated coding application.

• Implement modifiers, CCI bundling guidelines, and Reason Not Billable (RNB) designations as necessary.

• Code all standard cases within 7 calendar days of receipt/discharge; prioritize cases to be completed within one business day.

• Resolve conflicting, ambiguous, or nonspecific documentation; consult VHA coding guidelines as needed.

• Adhere to all HIPAA, VA/VHA privacy, security, and records management regulations, completing all required VA training prior to system access and annually thereafter.

• Follow AHIMA Standards of Ethical Coding.

• Conduct coding audits on at least 5% of coded services; provide written feedback to team members, monitor quality trends, and report metrics to Arrow ARC PM weekly.

• Ensure team coding production aligns with contract and program office standards, which includes a minimum of 70 outpatient or 13 inpatient encounters per coder per 8-hour day, and achieving a 95% accuracy rate per HIMS program office requirements.

• Act as the primary contact for contract team coding inquiries and VA coding-related questions, including documentation clarification, VHA policy, and contract compliance issues.

• Guide and assist coders transitioning into VA/VHA coding environments; support onboarding and ongoing education as required.

• Engage in VA-directed coding reviews, pre-bill re-reviews, or RAC/MAC audits as applicable.

⛳️ Requirements

• Active coding credential from AHIMA (RHIA, RHIT, CCS, or CCS-P) or AAPC (CPC or CPC-H); this credential must be maintained throughout the contract duration.

• Expertise in ICD-10-CM, ICD-10-PCS, CPT/HCPCS, DRG assignment, and E&M guidelines.

• Experience with VA systems (e.g., VistA/CPRS, VIRR) and adherence to HIPAA/VA regulations.

• At least 3 years of VHA facility coding experience, including current or recent experience (within the last 12 months) in a lead, supervisory, or senior coding role.

• Proven experience in conducting coding audits and providing feedback.

• Background in mentoring or training other coders.

🏝️ Benefits

• Flexible hours