Outpatient Medical Billing and Coding Analyst and Cost Reviewer [PR0001C] 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 who's mission is to provide a proactive and patient-centered system of health with the focus on the medical readiness of all Soldiers.
MD - Medical Billing & Coding Candidates shall work to support requirements as a 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 for the resolution of coding denials. Advises and instructs providers regarding billing and documentation policies, procedures, and regulations. Interacts with provider staff regarding conflicting, ambiguous or non-specific medical documentation, obtaining clarification of same; and educates providers regarding changes and measuring compliance. Develops preventive measures in response to patterns identified through analysis of claims denial data and HCC reviews; prepares periodic reports for the HCC findings, trends and clinical staff identifying corrective measures necessary to resolve denial problems. 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/Power point) and related tools and technology required for the position.
2 years of experience in medical coding and billing training, risk adjustment coding or Hierarchical Condition Category (HCC) coding required; or equivalent combination of education and experience; (Medical terminology, anatomy & physiology required). Registered Health Information Technician (RHIT) Certified Coding Specialist – Professional (CCS-P) or Certified Coding Specialist (CCS) required. Certified coder through AHIMA or AAPC preferred but not required. Strong knowledge of CPT procedure codes and diagnostic ICD-10-CM codes and/or MS-DRG classification codes, and application of modifiers. 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, in accordance with Federal Travel Regulations.
LOCATION: Work shall be conducted CONUS - Fort Stewart, GA.
OTHER REQUIREMENTS Commitment: to work with smart, interesting people with diverse backgrounds to solve the biggest challenges across private, public and social sectors. Curiosity: the ideal candidate exhibits an inquisitive nature and the ability to question the status quo among a community of people they enjoy and teams that work well together. Humility: exhibits grace in success and failure while doing meaningful work where skills have impact and make a difference. Willingness: to constantly learn, share, and grow and to view the world as their classroom. BENEFITS AND HIGHLIGHTS ProSidian Employee Benefits and Highlights: Your good health and well-being are important to ProSidian Consulting. At ProSidian, we invest in our employees to help them stay healthy and achieve work-life balance.
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. 401(k) Retirement Savings Plan: 401(k) Retirement Savings Plans help you save for your retirement for eligible employees. 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. 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. 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 Vietnam era, or other eligible veteran status, or any other protected factor.
FOR EASY APPLICATION USE OUR CAREER SITE LOCATED ON http://www.ProSidian.com/ OR SEND YOUR RESUME'S, BIOS, AND SALARY EXPECTATION / RATES TO ******. ONLY CANDIDATES WITH REQUIRED CRITERIA ARE CONSIDERED.
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