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Guidehouse
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Quality Analyst Profee ED

Quality Analyst Profee ED

Guidehouse

5 - 9 years

0 Lacs

chennai tamil nadu

Posted:6 days ago| Platform: Shine logo

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Skills Required

medical coding

Work Mode

On-site

Job Type

Full Time

Job Description

You will be responsible for planning, monitoring, directing, and evaluating QA production on a daily basis. Ensuring that daily schedules are met and communicating with the Director and Coding Operations if situations occur that hinder meeting deadlines. In case of system issues or emergencies delaying QA, you will implement measures/schedules to return to established schedules promptly. This should be done in close collaboration with each quality specialist to ensure client requirements are met satisfactorily. Your role will involve reviewing medical record documentation for accuracy in code assignment of primary/secondary diagnoses and procedures using ICD-9-CM and CPT-4 coding conventions. You will also sequence the diagnoses and procedures according to coding guidelines and ensure accurate MS-DRG/APC assignment when applicable. Abstracting and compiling data from medical records for appropriate reimbursement will be part of your responsibilities, especially for reviewing code assignments that are not straightforward or when documentation in the record is inadequate, ambiguous, or unclear for coding purposes. You will be expected to answer queries from the quality staff on a daily basis and escalate to the Director of Coding as necessary. Meeting agreed sampling targets and accuracy, keeping abreast of coding guidelines and reimbursement reporting requirements, documenting QA data on teams of QA/coders, and recording findings in the QA system for reporting to the client will also be part of your duties. Additional responsibilities include coordinating continuing education for all coding/QA teams, scheduling quality meetings with the QA and production staff, bringing identified concerns to Guidehouse's coding compliance management for discussion, actively participating in project launch sessions, and maintaining a thorough understanding of anatomy, physiology, medical terminology, disease processes, and surgical techniques for effective application of ICD-9-CM and CPT-4 coding guidelines. You are required to have at least 5+ years of experience as an accredited medical coder (CCA, CCS, CPC, CPC-H) and possess key skills in Medical Coding. Profee Audit Experience and Good Analytical Skills would be considered nice-to-have qualifications for this role. Furthermore, you should understand and abide by the organization's information security policy to protect the confidentiality, integrity, and availability of all information assets and report any security incidents related to information promptly. Guidehouse offers a competitive compensation and flexible benefits package to create a diverse and supportive workplace. As an Equal Opportunity Employer, Guidehouse considers qualified applicants with criminal histories in accordance with applicable laws and regulations. If you require accommodation during the recruitment process, please contact Guidehouse Recruiting. Be aware that Guidehouse will not charge a fee or require a money transfer at any stage of the recruitment process and will not collect fees from educational institutions for participation in a recruitment event. If you encounter any unauthorized requests for money related to a job opportunity with Guidehouse, please report the matter to Guidehouse's Ethics Hotline.,

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