1. Work as part of the Quality Assurance Team to perform daily coding quality assurance reviews under the supervision of the QA Manager
2. Perform random quality assurance audits utilizing the internal focus target lists developed from CMS, and approved RAC issues, OIG workplan topics, and historical areas of concern, as directed by the QA Manager.
3. Comply with the established internal and client-requested QA guidelines.
4. Coordination with assigned client contacts to review departmental procedures and ensure compliance.
5. Prepare weekly QA productivity and progress reports to QA Manager.
6. Ensure strict adherence to HIPAA policies.
7. Provide review findings and feedback to coding staff in a constructive manner.
8. Complete work assignments within the expected timeframe.
9. Apply ICD-10-CM Official Coding Guidelines, Coding Clinic advice, MCE/OCEs,
and other regulatory requirements in the coding and review process.
10. Develops departmental SOP's as needed. Participates in local and enterprise-wide initiatives to promote data quality and quality improvement.
11. Computes and reports statistical QA data in a variety of formats, without computational errors, spotting trends and/or patterns
Skillset and Quaification
- 5+ years total experience in Medical Coding as QA / SME / Specialist / Supervisor / Mentor in IP DRG Coding in Operations or Quality team
- 6–12 months of documented Team Lead experience good to have
- Strong knowledge of IP DRG
- CCS or CIC certification or CPC or COC
- Life Science graduate
- Ability to perform secondlevel QA audits
- Team management, client reporting & qualified email communication skills
- Mandatory Work From Office