Quality Assurance Lead

11 hours ago

Aurangabad, Maharashtra, India Gebbs Healthcare Solutions Full time ₹ 5,00,000 - ₹ 12,00,000 per year

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.

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