Lead Medical Coder and Auditor

Lead Medical Coder and Auditor

ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value. ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations.

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

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; and 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.
• Outstanding oral and written communications skills
• Clinical background and previous chart abstraction experience is also preferred.

TRAVEL: Travel as coordinated with the technical point of contact and approved in writing by the Contracting Officer in advance, is allowed, in accordance with Federal Travel Regulations.

LOCATION: Work shall be conducted CONUS - Fort Stewart, GA

• 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