Sr Medical Coders - Qa/Denials

Summary Description:

A Medical Coding QA will require review of the coded charts and provide feedback to coders on corrections made along with coding references. RCA (Root Cause Analysis) should be made and shared with the training team for deep dive analysis and action plan for quality improvement. Collaborate with all stakeholders for quality improvement and meet client service level agreement (SLA). Have a thorough understanding of client specifications and specialty coding guidelines. Review coded charts as per the client specification and coding nomenclature while following general coding guidelines. Provide feedback to coders along with coding references for improving quality and productivity.

• Fully Remote
• Must have Oncology and Radiation experience
• Coding certificate required
• Hours: 8am-7pm (staggered shifts within these hours)

Daily Responsibilities:

• New hire testing, publishing results and help in onboarding of new hire.
• Realtime help provided to users in operations such as blank busting to avoid critical coding errors and meet client SLA.
• Account specifications orientation.
• QPIP- feedback tracking and trending
• TNI basis error analysis.
• Provide support and training to users in QPIP.
• Coordinating with operations team to identify additional quality review requirements and provide necessary reviews accordingly.
• Collaborate with onshore/offshore teams to provide updates and feedback to users.
• Analyze quality and operations data and basis that create quality improvement activity and provide feedback to help improve quality and production.
• Perform any additional duties that may be assigned.
• Provide support/training for ad hoc.
• Quality report with all critical errors tracking.
• New sites transition training and eligibility qualification.

Skills and Education:

• Strong organizational skills; attention to detail and good group presentation skills.
• Consistently reports to work on time and prepared to perform duties of position
• Work under limited supervision with ability to understand and meet deadlines as workload necessitates.
• Proficient knowledge of medical terminology, ICD-9 and CPT coding.
• Ensure applicable laws and regulations of working with confidential information are adhered to.
• High school diploma and bachelor’s degree
• Part of the Revenue Integrity Department and provides support to departments within the Revenue Cycle.
• Excellent mathematical skills
• 5 years of experience as a coder and a minimum of 3 years of experience in quality analysis/chart reviews preferred.
• Excellent communication skills (written and verbal) and strong organizational skills.
• Requires advanced knowledge in coding, auditing, and documentation guidelines. Experience in Radiation/Medical Oncology (Specialty)
• Excellent typing and 10-key speed and accuracy
• Meet department productivity and quality standards.
• Medical Billing/Coding Diploma or Certificate Required

Benefits:

• Vision insurance
• Health insurance
• Life insurance
• 401(k)
• Dental insurance
• Paid time off