Lead Medical Coder and Auditor [PR0001D]

ProSidian Consulting•Fort Stewart, GA

11d•Onsite

About The Position

ProSidian Seeks a Lead Medical Coder and Auditor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on athe medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The Armed Forces' overall mission is "to fight and win our Nation's wars, by providing prompt, sustained, land dominance, across the full range of military operations and the spectrum of conflict, in support of combatant commanders". The Regional Health Command's Readiness Mission includes dental care of active duty Soldiers, public health services, veterinary services, and providing management and support to wounded, ill and injured Soldiers assigned to its seven warrior transition units. The ProSidian Engagement Team Members work to provide health coding services to a branch of the United States Armed Forces' Regional Health Command- Atlantic (RHC-A) military treatment facilities and provide services to MTFs located in the National Capital Region and the following RHC-A Medical Treatment Facility (MTFs) locations: AL | PR | FL | GA | KY | DC | MD | PA | VA | NY | NC | SC. Additionally, the vendor may be required to provide coding services to other military services (i.e. U.S. Navy, U.S. Air Force). The ProSidian Contract Service Providers (CSP) will work in conjunction with other health care providers, professionals, and non-contract personnel. MD - Medical Billing & Coding Candidates shall work to support requirements as a Lead Medical Coder and Auditor and review health record documentation for assignment of proper diagnosis and procedure codes utilizing system edits, Military Health System specific, and commercial coding guidance. This position will review and accurately code/audit office and hospital procedures for reimbursement. Review coding and abstracting on all patient types assigned to include the following: inpatient, ambulatory surgery, observation, ER, clinic and diagnostics in order to assure 96% coder accuracy (or as stipulated by contract). Audit vendor and internal risk adjustments coding to ensure accuracy and identify and mitigate any risks. Receive and review patient charts and documents for accuracy Ensure that all codes are current and active Report missing or incomplete documentation Meet daily coding production Review medical records and other source documents and collect clinical data according to specifications and guidelines provided by MHS Accurately enter data into abstraction software using a personal computer, keyboard and/or mouse Update and maintain document lists Performs accurate charge entries Ensure proper coding on provider documentation Serves as resource regarding insurance resolutions and coding questions Handles co-pays, balances, and charge posting Follow all DoD and DHA directives, guidance, instructions, policies, procedures, rules, and standards relating to protection of patient information and privacy practices. Follows coding guidelines and legal requirements to ensure compliance with federal and state regulations Maintain security and confidentiality of medical records and Protected Health Information (PHI) Performs additional duties assigned by Coding Manager as needed

Requirements

The Lead Medical Coder and Auditor shall have consecutive employment in a position with comparable responsibilities within the past five (5) years
Must be able to use a computer to communicate via email
Proficient in Microsoft Office Products (Word/Excel/Power point) and related tools and technology required for the position
Must Have A Minimum Of 2 Yrs Certification Of One Of The Following: a) American Health Information Management Association (AHIMA) Credentials: RHIA - Risk Health Information Administration | RHIT - Registered Health Information Technician | CCA - Certified Coding Associate | CCS- Certified Coding Specialist and/or b) American Academy of Professional Coders (AAPC): CPC - Certified Professional Coder | COC - Certified Outpatient Coder | CIC - Certified Inpatient Coder | CRC - Certified Risk Coder
Work products shall be thorough, accurate, appropriately documented, and comply with established criteria
The candidate shall ensure that duties are performed in a competent and professional manner that meets milestones/delivery schedules as outlined
Keys Skillset Attributes Required To be successful are Attention to Detail | Discretion | Computer Skills | Office Skills | Organizational Skills | Writing Skills | Operations | Coding | Quality | Compliance | Analytical abilities - to understand and analyze patients' health records, Strong morals, Social skills, Tech savvy
High school degree or equivalent; Bachelor’s degree in related field preferred
Medical Coding Certificate; RHIT or CPC by AAPC or AHIMA license; meet state licensure requirements
Maintain coding certification and attends in-service training as required
Two (2) years of medical coding experience
Understanding of medical terminology, anatomy and physiology
Ability to work independently or as an active member of a team
Strong computer skills in data entry, coding, and knowledge of Electronic Medical Record software; Microsoft Office Suite
Accurate and precise attention to detail
Knowledge of medical terminology, anatomy, physiology, and pathophysiology is preferred
Excellent oral and written communication skills
Attention to detail
Analytical and evaluation skills
Proficient with Microsoft Office Products (Microsoft Word, Excel, PowerPoint, Publisher, & Adobe)
U.S. Citizenship Required

Nice To Haves

Clinical background and previous chart abstraction experience is also preferred

Responsibilities

review health record documentation for assignment of proper diagnosis and procedure codes utilizing system edits, Military Health System specific, and commercial coding guidance
review and accurately code/audit office and hospital procedures for reimbursement
review coding and abstracting on all patient types assigned to include the following: inpatient, ambulatory surgery, observation, ER, clinic and diagnostics in order to assure 96% coder accuracy (or as stipulated by contract)
audit vendor and internal risk adjustments coding to ensure accuracy and identify and mitigate any risks
receive and review patient charts and documents for accuracy
ensure that all codes are current and active
report missing or incomplete documentation
meet daily coding production
review medical records and other source documents and collect clinical data according to specifications and guidelines provided by MHS
accurately enter data into abstraction software using a personal computer, keyboard and/or mouse
update and maintain document lists
performs accurate charge entries
ensure proper coding on provider documentation
serves as resource regarding insurance resolutions and coding questions
handles co-pays, balances, and charge posting
follow all DoD and DHA directives, guidance, instructions, policies, procedures, rules, and standards relating to protection of patient information and privacy practices
follows coding guidelines and legal requirements to ensure compliance with federal and state regulations
maintain security and confidentiality of medical records and Protected Health Information (PHI)
performs additional duties assigned by Coding Manager as needed

Benefits

Competitive Compensation: Pay range begins in the competitive ranges with Group Health Benefits, Pre-tax Employee Benefits, and Performance Incentives.
Group Medical Health Insurance Benefits: ProSidian partners with BC/BS, to offer a range of medical plans, including high-deductible health plans or PPOs.
Group Dental Health Insurance Benefits: ProSidian dental carriers - Delta, Aetna, Guardian, and MetLife.
Group Vision Health Insurance Benefits: ProSidian offers high/low vision plans through 2 carriers: Aetna and VSP.
401(k) Retirement Savings Plan: 401(k) Retirement Savings Plans help you save for your retirement for eligible employees. A range of investment options are available with a personal financial planner to assist you. The Plan is a pre-tax Safe Harbor 401(k) Retirement Savings Plan with a company match.
Vacation and Paid Time-Off (PTO) Benefits: Eligible employees use PTO for vacation, a doctor’s appointment, or any number of events in your life. Currently these benefits include Vacation/Sick days – 2 weeks/3 days | Holidays - 10 ProSidian and Government Days are given.
Pre-Tax Payment Programs: Pre-Tax Payment Programs currently exist in the form of a Premium Only Plan (POP). These Plans offer a full Flexible Spending Account (FSA) Plan and a tax benefit for eligible employees.
Purchasing Discounts & Savings Plans: We want you to achieve financial success. We offer a Purchasing Discounts & Savings Plan through The Corporate Perks Benefit Program. This provides special discounts for eligible employees on products and services you buy on a daily basis.
Security Clearance: Due to the nature of our consulting engagements there are Security Clearance requirements for Engagement Teams handling sensitive Engagements in the Federal Marketplace. A Security Clearance is a valued asset in your professional portfolio and adds to your credentials.
ProSidian Employee & Contractor Referral Bonus Program: ProSidian Consulting will pay up to 5k for all referrals employed for 90 days for candidates submitted through our Referral Program.
Performance Incentives: Due to the nature of our consulting engagements there are performance incentives associated with each new client that each employee works to pursue and support.
Flexible Spending Account: FSAs help you pay for eligible out-of-pocket health care and dependent day care expenses on a pre-tax basis. You determine your projected expenses for the Plan Year and then elect to set aside a portion of each paycheck into your FSA.
Supplemental Life/Accidental Death and Dismemberment Insurance: If you want extra protection for yourself and your eligible dependents, you have the option to elect supplemental life insurance. D&D covers death or dismemberment from an accident only.
Short- and Long-Term Disability Insurance: Disability insurance plans are designed to provide income protection while you recover from a disability.