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Medical Record Technician
Medical Record Technician-March 2024
Milwaukee
Mar 29, 2026
About Medical Record Technician

  JOB REQUIREMENTS: Duties Outpatient Coder MRTs perform the full scope ofoutpatient coding including ambulatory surgical cases, diagnosticstudies and procedures, outpatient encounters, and/or inpatientprofessional services. Outpatient coder duties consist of theperformance of a comprehensive review of documentation within the healthrecord to accurately assign ICD-10-CM codes for diagnoses, CPT/HCPCScodes for surgeries, procedures and evaluation and management services.They independently review and abstract clinical data from the record fordocumentation of diagnoses and procedures to ensure it is adequate andappropriate to support the assigned codes. They code all complicated andcomplex disease processes, patient injuries, and all procedures in awide range of ambulatory settings and specialties. They also directlyconsult with the clinical staff for clarification of conflicting,incomplete, or ambiguous clinical data in the health record. Majorduties include, but are not limited to the following: Assigns codes todocumented patient care encounters (inpatient facility and/orprofessional services) covering the full range of health care servicesprovided by the VAMC. Patient encounters are often complicated andcomplex requiring extensive coding expertise. Applies advanced knowledgeof medical terminology, anatomy & physiology, disease processes,treatment modalities, diagnostic tests, medications, procedures as wellas the principles and practices of health services and theorganizational structure to ensure proper code selection. Selects andassigns codes from the current version of several coding systems toinclude current versions of the International Classification of Diseases(ICD), Current Procedural Terminology (CPT), and/or Healthcare CommonProcedure Coding System (HCPCS). 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. Also applies codes based on guidelinesspecific to certain diagnoses, procedures, and other criteria used toclassify patients under the Veterans Equitable Resource Allocation(VERA) program that categorizes all VA patients into specific classesrepresenting their clinical conditions and resource needs. Monitorsever-changing regulatory and policy requirements affecting codedinformation for the full spectrum of services provided by the VAMC.Performs a comprehensive review of the patient health record to abstractmedical, surgical,... For full info follow application link. The UnitedStates Government does not discriminate in employment on the basis ofrace, color, religion, sex (including pregnancy and gender identity),national origin, political affiliation, sexual orientation, maritalstatus, disability, genetic information, age, membership in an employeeorganization, retaliation, parental status, military service, or othernon-merit factor. ***** APPLICATION INSTRUCTIONS: Apply Online:ipc.us/t/2004D0CD89984642

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