Medical Records Technician
- Quantitative Analysis - Performs comprehensive review of the record to assure the presence of all component parts, such as; correct name, health record number, signatures and dates where required, and all reports which appear to be indicated by the treatment rendered.
- Qualitative Analysis - Evaluates the record for documentation, consistency, accuracy and correlation of recorded data, such as medical necessity and modifier usage. Ensures the final diagnosis as stated by the physician is valid, complete and accurately reflects the care and treatment rendered.
- Assigns and sequences International Classification of Disease (ICD), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), Current Dental Terminology (CDT), Diagnostic and Statistical Manual of Mental Disorders (DSM) codes to diagnosis and procedures from documented information.
- Medico-legal Requirements - Makes the final determination that the record is complete, accurate, and reflects data to justify the diagnosis and warrant treatment without infringing on decisions concerning a physician's clinical judgment.
- Enters transaction codes and data from charge tickets or super bills.
- Adheres to all official coding guidelines, conventions, standards of ethical coding and rules established by the American Health Information Management Association (AHIMA), American Medical Association (AMA), Centers for Medicare & Medicaid (CMS) and the IHS.
- Provides ongoing education, updates and briefs physicians, nursing staff, and health care personnel within the immediate organization or work unit, on coding updates, rules, regulations, and guidelines.
- Generates daily reports to review, identifies errors, inconsistencies, discrepancies and/or trends and discusses with the appropriate medical, nursing, or health care providers, and recommends appropriate modifications to entry.
- Assists with performing routine audits in accordance with the facility Compliance Plan and Performance Improvement, which may include findings from provider documentation trends, coding peer reviews, and reimbursement denials.
Requirements
Conditions of Employment
- Selectee may be subject to a probationary/trial period
- ESEP appointees typically serve a two year trial period
- U.S. Citizenship is required
- Selective Service Registration is required for males born after 12/31/1959
- This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children. Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes.
- IHS Selectees that will work in an IHS health care facility may be subject to Employee Health Policies related to Measles and Rubella, COVID-19, and seasonal influenza immunizations. Vaccine exemption requests may be available according to the National and/or Service Unit guidance.
- Required to work on a rotational basis for shift, evening, weekend and holidays, providing after hour services and/or extended clinic hours to support patient care services.
- Successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit .
- You will need to set up direct deposit so we can pay you.
Qualifications
Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week.
MINIMUM QUALIFICATIONS:
GS-05: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-4 grade leave in the Federal Service obtained in either the private or public sector. or, successfully completed four (4) years above high school leading to a bachelor's degree. Specialized experience in performing the following type of work and/or tasks: Experience with medical coding in a small hospital or clinic office setting. Knowledge of medical terminology, medical abbreviations, pharmaceutical and hospital terms by documenting into patient records for billing purposes.
Substitution of Education for experience: This education must have obtained in an accredited business, secretarial or technical school, junior college, college or university. One year of full-time academic study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university, or at least 20 hours of classroom instructions per week for approximately 36 weeks in a business, secretarial or technical school.
GS-6: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-5 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Experience in medical coding in a hospital or clinic setting, coding internal medicine, OB/GYN and other ancillary services. Knowledge of coding terminology, performing chart analysis, and following well establish medical record policies and procedures; analyze, interpret and abstract data from clinical documentation and/or electronic health record and assign correct diagnostic and procedure codes.
GS-7: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-6 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Experience in medical coding in a hospital, coding surgery, emergency medicine, and other specialty clinical services, such as cardiology, rheumatology and podiatry. Applying extensive, well-established medical records procedures sufficient to analyze the consistency of medical records involving a wide range of diseases, medical and surgical procedures, ensure medical records contain appropriate documentation to support the principal procedure, qualifying complications, and co-morbidities; and consult with medical and clinical staff for clarification and additional required information; research and resolve complex coding cases independently, review and correct all errors with little or no supervision.
QUALITY RANKING FACTOR:
Must possess certification by the American Health Information Management Association (AHIMA) as a Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P) and/or certification by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) or Certified Professional Coder-Hospital (CPC-H). (Provide a copy of your certification with your application).
Time In Grade
Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP).
You must meet all qualification requirements within 30 days of the closing date of the announcement.
Education
This position has an education requirement. You are strongly encouraged to submit a copy of your transcripts or a list of your courses including titles, credit hours completed, and grades. Unofficial transcripts will be accepted in the application package. Official transcripts will be required from all selectees prior to receiving an official offer.
Only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education may be credited. Applicants can verify accreditation at the following website: .
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 .
Additional information
Additional selection(s) of candidates may be possible within 240 days from the date the certificate of eligibles was issued for this announcement.
Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. IHS may offer newly-appointed Federal employees credit for their directly related previous non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave.
This position is covered by a Bargaining Unit.
This position has promotion potential to the GS-7 grade level. Promotion to the next grade level is at management's discretion and is based on your demonstrated ability to perform the higher level duties, the continuing need for the higher level duties, and "Regulatory/Administrative" approval. Promotion to the next higher grade level is not guaranteed and no promise of promotion is implied.
- Benefits
A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. .
Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.
Conditions of Employment
- Selectee may be subject to a probationary/trial period
- ESEP appointees typically serve a two year trial period
- U.S. Citizenship is required
- Selective Service Registration is required for males born after 12/31/1959
- This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children. Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes.
- IHS Selectees that will work in an IHS health care facility may be subject to Employee Health Policies related to Measles and Rubella, COVID-19, and seasonal influenza immunizations. Vaccine exemption requests may be available according to the National and/or Service Unit guidance.
- Required to work on a rotational basis for shift, evening, weekend and holidays, providing after hour services and/or extended clinic hours to support patient care services.
- Successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit .
- You will need to set up direct deposit so we can pay you.
Qualifications
Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week.
MINIMUM QUALIFICATIONS:
GS-05: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-4 grade leave in the Federal Service obtained in either the private or public sector. or, successfully completed four (4) years above high school leading to a bachelor's degree. Specialized experience in performing the following type of work and/or tasks: Experience with medical coding in a small hospital or clinic office setting. Knowledge of medical terminology, medical abbreviations, pharmaceutical and hospital terms by documenting into patient records for billing purposes.
Substitution of Education for experience: This education must have obtained in an accredited business, secretarial or technical school, junior college, college or university. One year of full-time academic study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university, or at least 20 hours of classroom instructions per week for approximately 36 weeks in a business, secretarial or technical school.
GS-6: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-5 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Experience in medical coding in a hospital or clinic setting, coding internal medicine, OB/GYN and other ancillary services. Knowledge of coding terminology, performing chart analysis, and following well establish medical record policies and procedures; analyze, interpret and abstract data from clinical documentation and/or electronic health record and assign correct diagnostic and procedure codes.
GS-7: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-6 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Experience in medical coding in a hospital, coding surgery, emergency medicine, and other specialty clinical services, such as cardiology, rheumatology and podiatry. Applying extensive, well-established medical records procedures sufficient to analyze the consistency of medical records involving a wide range of diseases, medical and surgical procedures, ensure medical records contain appropriate documentation to support the principal procedure, qualifying complications, and co-morbidities; and consult with medical and clinical staff for clarification and additional required information; research and resolve complex coding cases independently, review and correct all errors with little or no supervision.
QUALITY RANKING FACTOR:
Must possess certification by the American Health Information Management Association (AHIMA) as a Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P) and/or certification by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) or Certified Professional Coder-Hospital (CPC-H). (Provide a copy of your certification with your application).
Time In Grade
Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP).
You must meet all qualification requirements within 30 days of the closing date of the announcement.
Education
This position has an education requirement. You are strongly encouraged to submit a copy of your transcripts or a list of your courses including titles, credit hours completed, and grades. Unofficial transcripts will be accepted in the application package. Official transcripts will be required from all selectees prior to receiving an official offer.
Only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education may be credited. Applicants can verify accreditation at the following website: .
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 .
Additional information
Additional selection(s) of candidates may be possible within 240 days from the date the certificate of eligibles was issued for this announcement.
Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. IHS may offer newly-appointed Federal employees credit for their directly related previous non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave.
This position is covered by a Bargaining Unit.
This position has promotion potential to the GS-7 grade level. Promotion to the next grade level is at management's discretion and is based on your demonstrated ability to perform the higher level duties, the continuing need for the higher level duties, and "Regulatory/Administrative" approval. Promotion to the next higher grade level is not guaranteed and no promise of promotion is implied.