Coding QC Analyst

Coding QC Analyst Responsibilities and Metrics

Are you looking for your next challenge? The Virtual Business Office Associates is the perfect balance of a diverse and growing workforce that still feels like home. If you are a Coding Professional with extensive experience, come join our best in KLAS Extended Business Office today!

Hiring remotely from: FL, GA, TX, NC, SC, VA, KY, AL.

FLSA Status:
Exempt

• Add to your portfolio by joining our fast-paced, exciting, diverse and inclusive work environment
• Endless growth opportunities and continuous professional development
• You’ll support one of the largest professional services firms in the world, with access to cutting edge automation and AI technologies to enhance your workday experience
• A permanent position with our company that offers stability and growth opportunities
• A flexible schedule that allows you to enjoy a work life balance, and leave early on Friday’s
• Comprehensive employee benefits

• Oversees daily coding quality control review team and coding trainer to ensure quality remains at or above 95% accuracy for the coding team both onshore and offshore.
• Directs and coordinates all training activities of quality control analyst and coding trainer engaged in reviews of coding activities
• Performs data quality reviews on inpatient/outpatient encounters to validate the ICD-10-CM, ICD-10- PCS, CPT, and HCPCS Level II code and modifier assignments, DRG/APC group appropriateness.
• Oversee monthly quality reviews of implemented policies Ensures that all turnaround times and quality measurements are met
• Keeps abreast of coding guidelines and reimbursement reporting requirements.
• Documents findings of analysis. Prepares reports and suggest recommendations of implementation of new systems, procedures, or organizational changes.
• Identifies areas of weakness and communicates recommendations on changes and improvement to Assistant Director, Manager and Team Leads and Coding teams.

• Current AHIMA credentials (i.e. CCS, CCS-P) or AAPC credentials (i.e. COC, CIC, CPC, CPC-H) required and maintained
• 10+ years of medical coding experience (facility and/or consulting) to include both inpatient and outpatient and quality control reviews in an acute care setting
• 3+ years of experience in Medical Collections, back-end A/R, and claim review in which denial follow up was worked
• Demonstrate advanced to expert level coding competency in ICD-10-CM, ICD-10-PCS, CPT-4, HCPCS and Coding Modifiers and displays advanced competency of Inpatient/Outpatient coding guidelines and Diagnosis Related Group (DRG)/Ambulatory Payment Category (APC) assignment