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Outpatient Medical Billing and Coding Analyst and Cost Reviewer
2 months ago
- Full-time
ProSidian is looking for "Great People Who Lead" at all levels in the organization. Are you a talented professional ready to deliver real value to clients in a fast-paced, challenging environment? 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 Outpatient Medical Billing and Coding Analyst and Cost Reviewer (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command whose mission is to provide a proactive and patient-centered system of health with the focus on the medical readiness of all Soldiers.
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. Additionally, the vendor may be required to provide coding services to other military services (i.e. U.S. Navy, U.S. Air Force).
MD - Medical Billing & Coding Candidates shall work to support requirements as an Outpatient Medical Billing and Coding Analyst and Cost Reviewer and review outpatient health records and/or Electronic Medical Record (EMR) for appropriate evaluation and management services. This position will validate provider, vendor, and internal diagnosis coding for accuracy by reviewing and analyzing samples of coding and claims extract compared to actual medical records.
- Prepares and maintains a variety of statistical reports and records while ensuring strict confidentiality of financial and medical records.
- Responsible for resolving questions, inconsistencies, or missing information.
- Conducts high level of bill review.
- Resolves daily coding scrubber errors to ensure accurate coding structure for correct billing.
- Resolves claim denials related to coding errors; performs coding charge corrections and rebilling as required.
- Advises and instructs providers regarding billing and documentation policies, procedures, and regulations.
- Interacts with provider staff regarding conflicting, ambiguous or non-specific medical documentation.
- Develops preventive measures in response to patterns identified through analysis of claims denial data.
- Compiles and reports HCC statistical data.
The Outpatient Medical Billing and Coding Analyst and Cost Reviewer 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/PowerPoint).
Must Have A Minimum Of 2 Yrs Certification Of One Of The Following: a) AHIMA Credentials: RHIA, RHIT, CCA, CCS and/or b) AAPC: CPC, COC, CIC, CRC.
- 2 years of experience in medical coding and billing training, risk adjustment coding or HCC coding required.
- Registered Health Information Technician (RHIT) Certified Coding Specialist – Professional (CCS-P) or Certified Coding Specialist (CCS) required.
- Experience with various risk adjustment methodology and chart audits.
- Strong knowledge of CPT procedure codes and diagnostic ICD-10-CM codes.
- Ability to use computer software. Excellent communication, basic math, and reasoning skills.
- 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.
LOCATION: Work shall be conducted CONUS - Fort Stewart, GA.
OTHER REQUIREMENTS
- Business Tools: understanding and proficiency with business tools and technology, including Microsoft Office.
- Commitment: to work with diverse backgrounds to solve challenges across sectors.
- Curiosity: the ideal candidate exhibits an inquisitive nature.
- Willingness: to constantly learn, share, and grow.
BENEFITS AND HIGHLIGHTS
ProSidian Employee Benefits: Your good health and well-being are important to ProSidian Consulting. We are pleased to offer the Employee Benefits Program, designed to promote your health and personal welfare. Our benefits currently include:
- Competitive Compensation: Pay range begins in competitive ranges with Group Health Benefits.
- Group Medical Health Insurance Benefits: ProSidian partners with BC/BS to offer a range of medical plans.
- 401(k) Retirement Savings Plan: A range of investment options are available with a personal financial planner.
- Vacation and Paid Time-Off (PTO): Eligible employees use PTO for vacation, a doctor’s appointment, or any number of events.
- Security Clearance: Due to the nature of our consulting engagements there are Security Clearance requirements.
ProSidian Consulting is an equal opportunity employer and considers qualified applicants for employment without regard to race, color, creed, religion, national origin, sex, sexual orientation, gender identity and expression, age, disability, or veteran status. All your information will be kept confidential according to EEO guidelines.
FOR EASY APPLICATION USE OUR CAREER SITE LOCATED ON OR SEND YOUR RESUME’S TO CAREERS@PROSIDIAN.COM.
ONLY CANDIDATES WITH REQUIRED CRITERIA ARE CONSIDERED.
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