Description

Verve, LLC is seeking an experienced Medical Coder to support federal healthcare operations. The Medical Coder will be responsible for reviewing, analyzing, and accurately assigning ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes to medical records and healthcare encounters while ensuring compliance with federal coding standards, payer regulations, and organizational policies.

The ideal candidate will possess extensive coding experience within either the Defense Health Agency (DHA), Military Health System (MHS), or Department of Veterans Affairs (VA) healthcare environments and demonstrate a thorough understanding of federal healthcare documentation and reimbursement requirements.

Requirements

Medical Coding & Documentation Review

• Review and analyze medical records, clinical documentation, operative reports, diagnostic results, and provider notes to assign accurate diagnosis and procedure codes.
• Apply ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding standards in accordance with federal regulations and coding guidelines.
• Ensure coding accuracy, completeness, specificity, and compliance with payer requirements.
• Abstract and validate clinical data from electronic health records and other healthcare systems.
• Identify documentation deficiencies and collaborate with providers and clinical staff to obtain clarification when necessary.

Quality Assurance & Compliance

• Conduct coding quality reviews and internal audits to ensure compliance with federal coding standards and organizational policies.
• Maintain current knowledge of coding regulations, CMS guidance, DHA requirements, VA directives, and industry best practices.
• Assist with corrective action plans and coding improvement initiatives.
• Support audit activities and provide documentation necessary to address coding inquiries and findings.

Reporting & Collaboration

• Generate coding-related reports and productivity metrics.
• Collaborate with clinicians, case managers, utilization review staff, revenue cycle teams, and federal program stakeholders.
• Participate in training, education, and process improvement initiatives.
• Assist leadership with coding analysis and operational support activities as assigned.

Required QualificationsEducation

• High School Diploma or equivalent required.
• Associate's or Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, or related field preferred.

Certifications (Required)

Must possess one of the following active coding credentials:

• Certified Professional Coder (CPC)
• Certified Coding Specialist (CCS)
• Certified Coding Associate (CCA)
• Certified Inpatient Coder (CIC)
• Registered Health Information Technician (RHIT)
• Registered Health Information Administrator (RHIA)

Experience (Required)

• Minimum of three (3) years of professional medical coding experience.
• Minimum of two (2) years of coding experience supporting the Defense Health Agency (DHA), Military Health System (MHS), Department of Veterans Affairs (VA), Veterans Health Administration (VHA), or other federal healthcare programs.
• Demonstrated experience utilizing ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding systems.
• Experience working with electronic health record systems and coding software applications.

Knowledge, Skills, and Abilities

• Comprehensive knowledge of federal healthcare coding regulations and reimbursement methodologies.
• Strong understanding of DHA, MHS GENESIS, CHCS, AHLTA, VistA/CPRS, Cerner, or other federal healthcare systems.
• Strong analytical, organizational, and problem-solving skills.
• Excellent verbal and written communication skills.
• Ability to manage multiple priorities while meeting productivity and quality standards.
• Ability to work independently and collaboratively within a team environment.

Preferred Qualifications

• Certified Professional Medical Auditor (CPMA).
• Experience supporting military treatment facilities (MTFs) or VA medical centers.
• Experience performing coding audits, compliance reviews, and provider education.
• Knowledge of federal healthcare quality measures and performance improvement programs.

Security Requirements

• Must be a U.S. Citizen.
• Must be able to successfully pass a federal background investigation and obtain all required system access credentials.

Work Location

• Remote or Hybrid (based on contract requirements).

Employment Type

• Full-Time

Equal Opportunity Employer

Verve, LLC is an Equal Opportunity Employer and is committed to fostering an inclusive workplace that values diversity and equal employment opportunities.