Quality Assurance Lead

1 week ago

Aurangabad India GeBBS Healthcare Solutions Full time

Job Description Position: Quality Assurance Specialist Coding Location: Aurangabad ( Sambhaji Nagar), Maharashtra Key Responsibilities - Conduct daily coding quality assurance (QA) reviews as a member of the QA team, under the guidance of the QA Manager. - Perform random QA audits using internal focus lists, derived from CMS, RAC-approved issues, OIG work plan topics, and historical risk areas, as directed by the QA Manager. - Adhere to established internal and client-specific QA guidelines at all times. - Coordinate with designated client contacts to review departmental procedures and verify compliance. - Prepare and present weekly QA productivity and progress reports to the QA Manager. - Maintain strict compliance with HIPAA and all applicable privacy regulations. - Deliver review findings and provide constructive feedback to coding staff. - Complete assigned work within prescribed deadlines. - Apply established guidelines and regulatory requirements (ICD-10-CM Coding Guidelines, Coding Clinic advice, MCE/OCEs) during all coding and review activities. - Develop departmental Standard Operating Procedures (SOPs) as needed; participate in data quality and improvement initiatives across local and enterprise settings. - Calculate and report statistical QA data accurately, identifying trends and patterns effectively. - Provide backend support as needed. - Work with management to identify and implement improvements to operational procedures for better efficiency and quality outcomes. Required Skills & Knowledge - Graduate with a minimum of 5 years of experience in medical coding, specifically focused on surgery coding. - Currently serving in a QA, Senior Coder, or equivalent capacity and eligible to step into a Team Leader role. - Willingness and readiness to work from the office. Disclaimer: GeBBS never charges fees or accepts payments for job applications. Any such requests should be reported immediately to [Confidential Information].

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