Quality Analyst Medical Coding

Job Description

Job Family: Coding Quality OP (India) Travel Required: None Clearance Required: None What You Will Do: Plans, monitors, direct and evaluate QA production on a daily basis. Ensures that daily schedules are met and communicates with Director, and Coding Operations if situations occur that hinder meeting deadlines. If system issues or other emergencies delay QA, an implement measures/schedules to return to established schedules at the earliest possible time. This should be done closely with each quality specialist to ensure the needs are met and that satisfy our client requirements. Responsible for ensuring that the QA communicates a valid, workable schedule for his or her client each week. Accurate, sensible & on-time.**If this doesn?t happen properly, it?s the responsibility of the Lead QA Specialist to make it happen promptly. Review medical record documentation for accuracy in code assignment of the primary/secondary diagnosis and procedures using ICD-9-CM and CPT-4 coding… conventions. Sequence the diagnosis and procedures using coding guidelines. When applicable, ensure MS-DRG/APC assignment is accurate. Abstract and compile data from medical records for appropriate optimal/complaint reimbursement for hospital and/or professional charges. This involves reviewing code assignments that are not straightforward or the documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Answers queries from the quality staff on a day to day basis and escalating to the Director of Coding as necessary. Meets agreed sampling targets and accuracy. Keeps abreast of coding guidelines and reimbursement reporting requirements. Documents QA data on teams of QA/coders and records findings in the QA system (RevAudit), which will be for reporting to the client, identifying risk areas, development of training and education programs and development/implementation of standardization within the organization. This also involves guidance and mentorship of coders. Helps to ensure that continuing education is planned, scheduled and completed for all coding/QA teams through the coordination of the US. Coordinates scheduled quality meetings with the QA and production staff. Brings identified concerns to RevenueMed?s coding compliance management for discussion. Project Launch – Active involvement in project launch sessions along with team leaders to understand the coding process. Have a rotational arrangement and is flexible to work with any given team as assigned. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines. – Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques to effectively apply ICD-9-CM and CPT-4 coding guidelines to inpatient and outpatient diagnoses and procedures. Assist with research and development and presentation of continuing education programs on areas of specialization. Assist with special projects as required. Example: Focused audits; client launches, etc. Shall understand and abide by the organizations? information security policy and protect the confidentiality, integrity and availability of all information assets. Shall report incidents related to security of information to concerned authorities. What You Will Need: Experience in Denial Management, E/m coding & Office procedures. Specialties ? OB Gyn, Pediatrics Any Life science, Paramedical Graduates and Post Graduates. Minimum Experience: 3-5 year experience. Basic Skill set: Accredited medical coders (CCA, CCS, CPC, CPC-H) with at least 3+ years? experience. ? Strong ability to interpret medical records of the patients in different specialties. ? Ability to communicate, have excellent interpersonal, listening skills and organizational skills. ? Can work in toughest of conditions, able to handle diverse clients. ? Able to work under pressure and deliver expected daily productivity targets. ? Ability to work with speed and accuracy. What Would Be Nice To Have: What We Offer: Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace. About Guidehouse Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation. If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting via email at [email protected]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation. Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee. Guidehouse is a leading global provider of consulting services to the public sector and commercial markets, with broad capabilities in management, technology, and risk consulting. By combining our public and private sector expertise, we help clients address their most complex challenges and navigate significant regulatory pressures focusing on transformational change, business resiliency, and technology-driven innovation. Across a range of advisory, consulting, outsourcing, and digital services, we create scalable, innovative solutions that help our clients outwit complexity and position them for future growth and success. The company has more than 13,000 professionals in over 50 locations globally. Guidehouse is a Veritas Capital portfolio company, led by seasoned professionals with proven and diverse expertise in traditional and emerging technologies, markets, and agenda-setting issues driving national and global economies. For more information, please visit guidehouse.com