Lead Medical Coder and Auditor [PR0001D]

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