Contract Medical Billing and Coding Manager [PR0001A]

Contract Medical Billing and Coding Manager

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Job Description

ProSidian Seeks a Contract Medical Billing & Coding Manager (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 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 Contract Medical Billing & Coding Manager and As a ProSidian Contract Medical Billing & Coding Manager you will manage the medical coding staff to ensure accuracy, consistency, and efficiency in relation to code assignment for reimbursement and reporting purposes. The Medical Billing & Coding Manager also functions as a great partner, promotes a service mentality, and drives to exceed customer expectations and needs. The Medical Billing & Coding Manager shall oversee medical coding staff, clients, and projects. This position will supervise the audit of coded medical records, communicate all coding issues with the appropriate clinical staff members, and identify solutions for project, process, or client challenges. Manage project finances and report results while adhering to Military Health System policies. Will ensure quality and productivity remain at the expected level.

• Labor management including overseeing production goals, managing employee schedules and performance, and provides opportunities for continuing education and cross-training.
• Manages, reviews and ensures quality initiatives are being met including reviewing claims reports, lag/productivity reports, daily volume/productivity reports, chart reviews, and accuracy rate.
• Works in conjunction with the Issue Resolution Teams on follow up and resolution of coding related denials and rejections to address any issues.
• Coordinates and reconciles multiple facility accounting schedules to ensure complete charge capture including coding complex operative procedures for surgical specialties.
• Functions as a subject matter expert and directs practices and other appropriate staff in surgical documentation, billing, coding, and reimbursement issues.
• Manages and executes audits for chart reviews and new providers.
• Acts as the main contact for division and practice coding issues, questions, and concerns.
• Monitors and supports IET resolution for responsible practices and works with appropriate leadership for resolution.
• Monitor health records documentation and coding operations.
• Train and manage coding professionals and ensure periodic interval training is provided to staff to ensure knowledge and skills are current and continuously improving.
• Develop staff schedules to cover clinic visit volumes adequately.
• Regularly collaborate with your team to maintain the satisfaction of patients.
• Verify compliance with DHA coding compliance plans, policies, and procedures, including review of the MTF coding compliance plan.
• Implement a DoD Health Records control process, which must include procedures to achieve a 97 percent availability of complete health records for coding while striving for 100 percent.
• Write and present reports on performance, compliance, and documentation issues.
• Ensure coding staff is current in MHS coding guidance and coding industry standards.

Qualifications

The Contract Medical Billing & Coding Manager 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. Medical billing is the process of submitting and following up on claims with health insurance companies in order to receive payment for services rendered by a healthcare provider. Medical billing translates a healthcare service into a billing claim. The main responsibility of a medical coder is to review clinical statements and assign standard codes using CPT, ICD-10-CM, and HCPCS Level II classification systems, etc. No healthcare facility can function effectively without medical billers, making certified professionals crucial in the healthcare industry.

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.

• Minimum 2 years of medical coding management experience in the DoD/Military Health System (MHS)
• Minimum of 2 years of experience in E/M, surgical coding, and/or reimbursement activities is required.
• AHIMA-certified Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT)
• ICD-10 certified
• Extensive knowledge of outpatient coding, coding guidelines, ICD-10-CM, CPT, HCPCS, medical dictionaries, and manual related to coding textbooks and glossaries; legal and regulatory requirements of medical records; medical records procedures, regulations, and principles to carry out a variety of medical records functions such as analysis, coding, ensuring compliance, and compiling data.
• 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.
• Must be proficient with eCW EMR, PatientKeeper charge capture system, and/or other related billing systems.
• Must be familiar with third party fee profiles and reimbursement requirements.
• Experience with Encoder Pro or AAPC Coder is highly preferred.

Medical billing is the process of submitting and following up on claims with health insurance companies in order to receive payment for services rendered by a healthcare provider. Medical billing translates a healthcare service into a billing claim. The main responsibility of a medical coder is to review clinical statements and assign standard codes using CPT, ICD-10-CM, and HCPCS Level II classification systems, etc. No healthcare facility can function effectively without medical billers, making certified professionals crucial in the healthcare industry.

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,