QA Coding

2 weeks ago

Hyderabad, India Advantum Health Full time

**Job Summary**

A Quality Analyst, working within the Advantum Process Improvement team, is responsible for monitoring compliance with billing rules/regulations by conducting reviews/audits of completed work files, educating professionals about workflow, process, documentation, and best practices; and recommending appropriate corrective actions surrounding revenue cycle services. Ensuring quality and integrity in the revenue cycle is key in this role.

This position reports to the Quality Manager or other appropriate administrator within the program. The position currently exists at the Advantum Health PMO Office. To be successful in this position, employees must have a knowledge of medical terminology, medical billing/coding rules, regulations, and documentation guidelines. This position requires excellent interpersonal skills. This position requires professional discretion due to the sensitive nature of the work performed.

**Qualifications**
- Certification in healthcare services, such as Certified Procedural Coder (CPC), and three years of experience in physician coding is highly preferred
- Knowledge of Medicare and Medicaid billing rules required
- Education in related field and/or the equivalent combination of training, education, and experience, required
- 5-7 Years Medical Revenue Cycle Management (RCM) experience required with a consistent track record of achieving results
- Knowledge of clinical workflow
- Process improvement mindset and ability to impact change is a must
- Expert in Microsoft Office Products, including Word and Excel

**Responsibilities**

The following list of duties provides examples of the most typical duties for positions in this job class. Individual positions may not include all of the examples listed, nor does this list include all work that may be assigned to positions in this job class.
- Conducts revenue cycle integrity monitoring in accordance with the Advantum Health policies and standards
- Accesses revenue cycle records and billing documentation to evaluate coding and billing performance, ensuring appropriate revenue cycle practices are utilized
- Creates reports of findings to include recommendations for process improvement
- Presents findings and feedback in a positive, helpful manner to appropriate parties and provide pertinent education or guidance to improve revenue cycle coding procedures
- Distributes and maintains auditing report records and logs
- Collaborates with the education team to ensure staff understanding of best practices in documentation, coding, billing, and other revenue cycle processes through presentations, correspondence, reports, training materials, personal meetings, or education sessions
- Researches via publications and web sites governmental regulations, Medicare, Medicaid and other payer rules and guidelines in order to: maintain current knowledge of appropriate billing procedures; assist staff with billing questions and issues; and aid in the development of training materials
- Maintains current knowledge of Advantum Health policies and guidelines related to documentation, coding, billing, revenue cycle, and as assigned, other professional integrity topics.
- Develops or assists in developing training materials. Participates in a positive, helpful, receptive manner at Quality staff meetings and at other Advantum Health meetings as assigned

**Job Types**: Full-time, Regular / Permanent

Pay: ₹500,000.00 - ₹1,035,296.06 per year

**Benefits**:

- Health insurance
- Internet reimbursement
- Leave encashment
- Provident Fund

Schedule:

- Day shift
- Monday to Friday

Ability to commute/relocate:

- Hyderabad, Telangana: Reliably commute or planning to relocate before starting work (required)

Application Question(s):

- Are you a certified CPC coder?

**Experience**:

- Medical coding (required)

Shift availability:

- Day Shift (required)

**Speak with the employer**
+91 9100337771

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