Quality Assurance Specialist
1 week ago
Job Title: Quality Assurance Specialist - Medical Coding
We are seeking a highly skilled Quality Assurance Specialist - Medical Coding to join our team. The ideal candidate will have a strong background in medical coding and quality assurance, with excellent analytical and problem-solving skills.
Key Responsibilities:
- Monitor Performance: Monitor the performance of all coding staff using key metrics, including daily coding volume, assignments worked, client project deadlines, and coding accuracy performance to achieve and maintain a 95% coding quality accuracy rate.
- Evaluate Production and QA Concerns: Escalate production and QA concerns or roadblocks to the Manager for involvement as needed.
- Collaborate with Training Teams: Work closely with the Training teams to communicate progress across the team to the Manager.
- Review Reports: Review both production and quality accuracy reporting and/or system reports on progress for all assigned projects and shares feedback.
- Motivate Team Members: Motivate team members through effective training and coaching to improve quality and professionalism.
- Conduct Team Meetings: Conduct monthly team meetings and annual performance evaluations with team members.
- Monitor Attendance Records: Monitor and maintain team attendance records and timesheet for coders.
- Complete Special Projects: Complete any special projects such as full coding audits and other duties as assigned.
- Mentor Staff: Mentor staff to maximize performance and potential.
- Enhance Job Satisfaction: Assist in maintaining and monitoring team member job satisfaction and morale.
- Domain Expertise: Demonstrate domain expertise in quality processes related to meeting production schedules and the coding of medical diagnoses and treatment practices.
- Coding Knowledge: Possess deep understanding of both production and quality assurance coding processes and guidelines in HCC risk adjustment coding.
- Analytical Skills: Utilize analytical and problem-solving skills, and the ability to use data to identify patterns and trends.
- Training Experience: Provide training, coaching, and development to team members, as well as provide regular feedback regarding work performance.
- Communication Skills: Possess strong communication skills to convey information across multiple team members with varying skill sets.
- Continuous Improvement: Focus on continuous improvement by working on projects that enable customers to arrest revenue leakage while complying with standards.
- Coding Education: Focus on updating coding skills and knowledge by participating in coding team meetings and educational conferences.
- Extensive Knowledge: Possess extensive knowledge of coding principles and guidelines.
- Hospital/Technical Systems: Possess extensive knowledge of hospital/technical and professional services reimbursement systems.
- Federal/State Regulations: Possess extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing for professional and technical services.
- Managerial Skills: Possess strong managerial, leadership, and interpersonal skills.
Qualifications:
- Education: Graduate or Post Graduate in Life Science, Pharmacy, Physiotherapy, Zoology, Microbiology discipline.
- Experience: 5+ years of industry experience.
- Certifications: CPC - Certified Coding Professional or CCS - Certified Coding Specialist.
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