Coding Quality Review Coordinator

Job Summary and Qualifications

Provides support assistance to the Coding Quality Review team. Assists with coordinating work flow, maintenance of internal schedules, assignments, and communication internally with vendors and/or HSCs and external customers. Assists with entry, tracking and compilation of data for productivity, quality scores, results reporting and education.

• Maintains schedule of coding quality review resource availability, both internally and vendor, according to established need.

• Assist with assignment of internal and vendor coding quality review resources.

• Assist with communication of internal and vendor work assignments.

• Assist with compilation of information for external audits.

• Compiles data and presentations for special reviews, AdHoc requests and projects (e.g. CAC, Cardiac, etc).

• Creates and utilizes review logs for data/updating reporting

• Provides status updates

• Compiles review data

• Assists with processing/data compilation for rebills

• Conducts quality control of internal productivity logs.

• Assists with maintenance of data and production of presentations for CQR MOR.

• Compiles weekly prebill and monthly target reports

• Assists with maintenance of CQR modeler.

• Monitors prebill and 3rd party mailboxes and coordinates work efforts according to established processes and timelines.

• Distributes exception logs to CQRs and monitors for completion.

• Updates prebill log when education plans are received.

• Distributes Internal Audit review results to CQRs and monitors for completion.

• Maintains IA report status document

• Upload Internal Audit initial communication tools, outcomes and accuracy results to manager/admin folder & individual CQRs' folder; create folders, set permission & site administrator

• Process Internal QC rebills, follow up, and create and implement new spreadsheets for Internal QC processes

• Maintain, Validates and Distributes Internal QC Volumes reporting

• Pulls and distributes monthly production reporting

• Uploads review logs to team rooms.

• Monitors prebill workflow for meeting SLA terms.

• Reports on compliance with SLA terms.

• Assists with tracking and coordination of appeals responses and processes.

• Utilized raw data from data analyst and produces meaningful information for customers.

• Creates Excel workbooks.

• Creates PowerPoint presentations.

• Prepares reports as needed

• Create and maintain CQR profile

• Assist with entry, calculation and tracking of productivity and/or quality data as needed

• Assist with tracking education requirements as needed

• Tracks team adherence to CIA and Healthstream requirements

• Workflow queue and/or CQA tool monitoring and follow-up

• Completes all required company education

• Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”

• Maintains knowledge of tools and resources, and associated workflows to include:
  Computer Assisted Coding (CAC), Electronic Health Records (EHR's), and data capture systems.

• Ownership Revision Creation of Process Documentation Job Aides.

• Contributes support of the Current State Reporting.

• Quarterly review of job duties, reporting, process documentation.

• Other duties as assigned such as monitoring processes within the Remote Workforce Management

• Maintains team roster-updates monthly

• Maintains a separate Outlook calendar of all birthdays and anniversaries and sends birthday and other important event announcements

• Maintains org chart-updates monthly

• Maintains onboarding/orientation checklists-leads updates by seeking input, creating drafts for mgmt. review and input, finalizing, communicating, maintaining in central location

• Maintains CQR shared drive

• Maintains CQR share point sites

• Uploads Internal Audit initial communication tools, outcomes and accuracy results

• Creates folders, sets permissions, and…