Medical Management Manager jobs in Abilene, TX

Destiny Management Services, LLC is a leading source of staffing services and business solutions to the Federal Government. Founded in 1996, we have provided job opportunities for more than 1000 employees nationwide in various fields.

We are looking for experienced professional medical coders for the medical treatment facility (MTF) and its geographic area of responsibility. 

1. Experience

• MSS personnel in this position are required to possess a minimum of three (3) years of medical coding and/or auditing experience in two (2) or more medical, surgical and ancillary specialties within the past 10 years. A minimum of one (1) year of performance in the specialty is required to be qualifying.

2. Other Knowledge, Skills and Abilities

• Practical knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT).
• Practical knowledge of reimbursement systems, including, but not limited to, Ambulatory Payment Classifications (APCs); and Resource-Based Relative Value Scale (RBRVS).
• Practical knowledge and understanding of industry nomenclature; medical and procedural terminology; anatomy and physiology; pharmacology; and disease processes.
• Practical knowledge of medical specialties; medical diagnostic and therapeutic procedures; ancillary services (includes, but is not limited to, Laboratory, Occupational Therapy, Physical Therapy, and Radiology); and revenue cycle management.

3. Coding Certifications:

• Note: A Registered Health Information Technician (RHIT) and Registered Health Information Administrator (RHIA) from AHIMA are acceptable to count for either a professional services coding certification or institutional coding certification, but not both.
• MSS personnel in this position are required to possess a current coding certification in good standing from EACH of the following categories:
• Professional Services Coding Certifications: The following are recognized professional certifications: Certified Professional Coder (CPC) or Certified Coding Specialist – Physician (CCS-P).
• Evaluation and Management (E&M) Auditor Certification: National Alliance of Medical Auditing Specialists (NAMAS) Certified Evaluation and Management Auditor (CEMA).

Coding Test - Contractor employees must achieve a minimum 70% passing score and the candidate’s score must be reported in the qualification documents by the Contractor. An incumbent employee who has previously passed a test approved by the AFMS MCPO may be exempted from this requirement.

Performance Outcomes
Accurately assigns diagnosis, procedure, and supply codes for the professional and institutional (facility) components of Outpatient encounters IAW DHA and AFMS MCPO completeness, productivity, and timeliness standards. Also, provides or contributes to periodic reports IAW DHA and AFMS MCPO instructions and timelines.

4. All Coding Personnel –

• Adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or Evaluation and Management code to ensure ethical, accurate, and complete coding.
• Monitors ever-changing regulatory and policy requirements affecting coded information for the full spectrum of services provided.
• Maintains technical currency through continuing education and training opportunities.
• Reviews encounter and/or record documentation to identify inconsistencies, ambiguities, or discrepancies that may cause inaccurate coding, medico-legal re-percussions or impacts quality patient care. Identifies any problems with legibility, abbreviations, etc., and brings to the provider’s attention. May perform assessments and examine records for proper sequence of documents, presence of authorized signatures, and sufficient data is documented that supports diagnosis, treatment administered, and results obtained. Develops and submits a written (electronic or hard copy) query IAW DHA or AFMS MCPO guidelines to the provider to request clarification of provider documentation that is conflicting, ambiguous, or incomplete in regards to any significant reportable condition or procedure. Monitors query submission, response times, and completion. Educates and provides feedback to providers and clinical staff to resolve documentation issues to support coding compliance. Assigns accurate codes to encounters based upon provider responses to queries and reports queries and responses IAW DHA or AFMS MCPO guidance.
• Acts as a source of reference to medical staff having questions, issues, or concerns related to coding. Responds to provider questions and provides examples of appropriate coding and documentation reference(s) to provide clarity and understanding. Based on contacts from the medical staff identifies training opportunities and works with coding training personnel to focus on consistency and clarity of coding advice provided. Collaborates with Medical Coding Trainers in developing, delivering, and monitoring initial and annual coding training to providers and clinical staff by providing guidance to professional and technical staff in documentation requirements for coding.
• Supports DHA and AFMS coding compliance by performing due diligence in ethically and appropriately researching and/or interpreting existing guides