Job Description

Full Time

* US Citizenship and the ability to obtain and maintain the clearance level stated above are required for this specific opportunity. Tria Federal (Tria) is unable to sponsor at this time.

Who We Are:

Tria Federal (Tria) is the premier middle-market IT services provider delivering digital transformation solutions to Civilian, Defense, and Intelligence agencies across the federal sector. With a future-forward vision and a mission rooted in service, we bridge capability gaps to help government agencies work faster, grow smarter, and stay nimble in the face of change. Wherever our customers are in their modernization journey, we are the trusted navigator in the path to possible.

#PoweringPossible

Who You Are:

You are a talented Revenue Integrity Medical Coder  with at least 2 years of experience and a passion for thinking big, taking action, and delivering exceptional results. You are outcome-driven, quality-obsessed, and relentlessly focused on innovation as a value-driver for world-class delivery, client satisfaction, and performance . You’re looking to grow as a professional in a team-oriented environment where you can put your fingerprint on mission-critical projects impacting the citizens we serve.

Military Veterans and individuals with disabilities are encouraged to apply! 

About This Role:

Tria Federal is seeking detail-oriented and credential Medical Coder to join our Defense Health Agency Revenue Integrity Team. This critical role focuses on ensuring the accuracy, completeness and compliance with medical coding to support optimal revenue capture and billing integrity within the Defense Health Agency. The incumbent will leverage their expertise in coding guidelines, billing rules, and MHS GENESIS (Cerner Millennium) electronic health record (EHR) system to validate charges, resolve coding-related edits, and mitigate revenue cycle risks. This position requires proactive management and resolution of coding and billing-related work queues. Ideal candidate would have an active security clearance with the DHA.

​​​​​​​Responsibilities:

• Coding for Revenue Accuracy
  • Review clinical documentation to accurately assign ICD-10-CM, CPT, and HCPCS Level II codes, with a specific focus on ensuring codes support medical necessity, charge capture, and compliance billing practices.
  • Apply modifiers correctly to ensure appropriate reimbursement and prevent denials.
  • Ensure coding complies with Official Coding Guidelines, payer regulations (including TRICARE), NCCI edits, and DoD/DHA policies impacting revenue.
• Revenue Cycle & Work Queue Management
  • Proactively utilize MHS GENESIS (Cerner Millennium) to review documentation, assign codes, and investigate coding-related revenue issues.
  • Actively monitor, prioritize, research, and resolve coding and billing-related edits found in electronic work queues (e.g. claim edits, charge review queues, pre-bill holds, coding validation queues, and denials management queues).
  • Meet established productivity and quality standards for coding accuracy, work queue resolution timeliness, and financial impact.
• Charge Validation and Reconciliation
  • May assist in validating that charges generated are appropriate and supported by clinical documentation and coding assignments.
  • Identify discrepancies between documented/coded services and captured charges, investigating and recommending corrective actions.
• Compliance and Auditing Support
  • Adhere strictly to HIPAA regulations and maintain patient confidentiality.
  • Stay current with coding updates, payer rules, reimbursement methodologies (DRG, APC, etc.), and federal/local regulations impacting revenue integrity.
• Collaboration and Process Improvement
  • Serve as a subject matter expert on coding guidelines related reimbursement and billing.
  • Provide feedback to client stakeholders regarding documentation improvement opportunities impacting revenue integrity.
  • Identify trends in work queue edits or denials and contribute to process improvement initiative to prevent recurrence.
  • Actively participate within project team(s) and engages with team members to ensure project objectives and client needs are met. Provides support and guidance as needed to ensure quality work products.
  • Adheres to all established project processes, procedures, and guidelines regarding resources and how to use them. Communicates with leadership regarding resource needs and communicates changes.
  • Adheres to defined work plans while maintaining all established timelines and deliverable deadlines.
  • Assists in developing effective internal and external presentations and skillfully helps to facilitate client and internal team meetings.
  • Ability to meet internal and external deadlines by efficiently managing time, prioritizing tasks, and utilizing available resources.
  • Accurately documents client communications and shares information with the project team.
  • Maintains effective communication with client and project team members.

The “Need-to-Have” Skills & Qualifications:

• Certification: Must possess and maintain a valid coding credential from AHIMA (e.g., RHIA, RHIT, CCS, CCS-P) or AAPC (e.g., CPC, COC, CIC, CPC-P).
• Experience: Minimum of 3+ years of recent medical coding experience, with demonstrated experience int asks related to revenue integrity, charge capture review, denial management, and resolving coding-related billing edits.
• EHR Experience: Demonstrated proficiency and hands-on experience using Cerner Millennium. Experience specifically with MHS GENESIS, including navigating coding, charge, and billing-related modules/work queue, is highly desirable.
• Work Queue Management: Proven ability to efficiently manage and resolve revenue cycle work queues, including coding edits, charge review, and pre-billing holds within an EHR system.
• Knowledge:
  • Expert knowledge of ICD-10-CM and CPT/HCPCS coding systems and guidelines.
  • Strong understanding of medical terminology, anatomy & physiology, and disease processes.
  • Strong understanding of healthcare revenue cycle processes, reimbursement methodologies, and payer requirements (especially TRICARE).
  • Familiarity with NCCI edits, LCDs/NCDs, and modifier usage impacting payment.
  • Knowledge of HIPAA, and healthcare compliance regulations related to coding and billing.
• Skills:
  • Exceptional attention to detail and accuracy.
  • Strong analytic, investigative, and problem-solving skills.
  • Proficient computer skills, including EHR navigation and Microsoft Office Suite.
  • Excellent written and verbal communication skills.
  • Ability to work independently, prioritize tasks, and meet deadlines in a production-driven environment.
  • Ability to analyze and interpret complex data, processes, and reports related revenue cycle and integrity.
• Access:  
  • Ideal candidate would have an active security clearance with the DHA.

N/A

Bachelor’s degree required, Finance, Business Administration, Healthcare Administration or related field preferred. Masters in Business Administration or related field, ideal.

Ability to Obtain and Maintain a Public Trust

2-4 or more years of consulting or healthcare experience required, preferably in a federal consulting environment.

The “Nice-to-Have” Skills & Qualifications:

• Experience coding and/or working work queues within the Military Health System (MHS), Department of Defense (DoD), or Department of Veterans Affairs (VA).
• Experience coding and/or working work queues in multiple specialties or encounter types (e.g., E/M, Surgery, Inpatient Facility).
• Bachelor’s degree in Health Information Management (HIM) or related field.
• Additional specialty coding credentials (e.g., CEDC, CASCC, etc.).

Why Tria?

What defines the Tria brand is more than just our dedication to excellence in our craft; it’s our incredible team of dedicated, talented, and passionate people that make Tria so exceptional. As people powering possible, we are all partners in our team’s shared success.

As a company that cares about people, we seek to cultivate a culture in which all can thrive personally and professionally. We offer a top-tier benefits package to invest in your physical, mental, and financial health and wellness so that you can be your best self - at work and in life. At Tria, we are growth-minded, entrepreneurial in spirit, and committed to fostering a culture of inclusion and opportunity for all. Whatever your background, your role, your department, or stage in your professional journey, here you will have opportunities to learn new skills, seize new challenges, and advance your career as we grow.

Job Listing ID: job_20230915161403_RNNPODATWHAUOEDF

Equal Employment Opportunity (EEO):

Tria Federal (Tria) is a Federal Contractor and EEO, OFCCP, VEVRAA, and Affirmative Action Employer.

As an Equal Employment Opportunity provider, Tria follows the protection of federal, state, and local law: Qualified applicants will receive consideration for employment without regard to race, color, creed, religion, age, national origin, marital status, disability, veteran status, sexual orientation, gender identity or expression, marital status, or genetic information.

U.S. Citizenship is required for this specific opportunity as Tria is unable to sponsor at this time. All selected applicants will be subject to a Minimal Background Investigation (MBI) and a government security investigation (when applicable) depending on the specific program and position listed. This includes but is not limited to: meeting the eligibility requirements for access to classified information and the ability to obtain a government-granted security clearance. Individuals may also be subject to a background investigation including, but not limited to: criminal history, employment verification, education verification, drug testing, and creditworthiness.

Qualified individuals with a disability have the right to request a reasonable accommodation. If you are unable or limited in your ability to use or access the Tria careers website as a result of your disability, please request a reasonable accommodation by sending an e-mail to hrhelp@triafed.com or call (703) 229-5888. Include the nature of your request, along with your name and contact information.

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