Coding Quality Assurance Coordinator

Role Overview

• Audit work is primary in coding RCM workflows and secondary responsibilities within the general RCM production teams, to ensure compliance with policies and procedures, expected system functionality usage, and departmental workflows
• Partner with the Education & Development department to assist in development and implementation of education programs based on identified quality issues
• Partner with colleagues to ensure all auditing needs are met
• Act as a Subject Matter Expert (SME) within the auditing team at both a national and regional level
• Complete user and workflow audits in a timely manner, enabling department leadership to use audit data to improve and drive positive changes
• Identify specific individual and department training needs, and assist in ongoing process improvement opportunities through audit analysis
• Review of policy changes, and implementation of those changes, into audit process and reporting
• Maintain up-to-date knowledge of department specific workflows, processes and system configuration updates, by actively partnering with RCM and coding leaders
• Provide feedback to the Education and Development team regarding training materials to ensure they are updated as needed
• Perform ad-hoc audits as needed
• Work with cross-functional teams to improve quality and performance through process improvement initiatives
• Maintain strictest confidentiality
• Participate in QA meetings, and be an active player in achieving annual departmental goals
• Responsible for developing and facilitating monthly reports, including content used for executive summaries
• Perform audits on peers to drive continuous improvements within the QA teams
• Review QA team’s backlog of work, and self-assign work as needed
• Performs other duties, as assigned

Requirements

• High School diploma or equivalent
• National Coding Certification (AHIMA, AAPC)
• Compliance auditing and Specialty Coding Education experience
• Clinical certification or experience preferred
• National Certification and Minimum of five years’ Experience in physician coding, Anesthesia/Pain Management, Surgery and E/M, ICD-10, with experience in Academic settings
• Proficiency in MS Office Excel, Word and Power Point
• Experience in Revenue Cycle and Claim processing
• Experience in Physician Billing Compliance preferred.
• Excellent verbal and written communication skills
• Ability to prioritize work
• Strong background in lifecycle of a claim, collection and billing knowledge is essential
• Must have keyboard skills with knowledge of Microsoft Word, Excel and PowerPoint
• Ability to adapt to a quick paced environment that may include changing priorities.
• Willing and eager to assist team members in achieving overall department productivity requirements.
• Strong time management skills.
• Ability to read, write, and speak English.

Benefits

• This position is eligible for a quarterly bonus. Bonuses are not guaranteed and are awarded based on company and individual performance.