Position: Coding Quality Assurance Specialist
The Coding Quality Assurance Specialist is responsible for conducting coding quality assurance activities for Health Information Services.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Manage audit procedures, diagnoses and modifiers based on clinical documentation, utilizing generally accepted coding standards and payer-specific policies where applicable
- Assess quality of clinical documentation to support quality initiatives
- Document audit findings using audit tools and standards; analyze findings and develop recommendations for key findings
- Generate audit summary reports and submit to the Coding Quality Assurance Specialist for review
- Act as a subject matter expert in the areas of coding and compliance
- Ensure healthcare information collected during the engagement is always secured
- Execute quality assurance special projects as assigned
- Assist Coding Quality Assurance Manager with discussion of audit findings with audited coding specialists as required
- Assist with coding related denial management, specifically conduct cross-client denial analysis, identify and communicate opportunities for operational or coding improvements to avoid denials, research and document coding guidelines as applicable
- Coordinate resolution of client inquiries
- Provide ongoing and periodic education to coding specialists on identified improvement opportunities to achieve coding quality standards
- Maintain an understanding of existing departmental workflows and systems
- Engage existing technologies and workflows in execution of auditing and consulting engagements when applicable
- Complete HAP’s compliance program training and achieve target score
- Support all compliance activities related to state, federal regulatory requirements, healthcare accreditation standards
- Assist with special projects and perform other duties as assigned
Knowledge and skills:
- Proficient in understanding and ability to enter data into medical billing software
- Ability to utilize a personal computer, multiple networks and internet navigation
- Intermediate knowledge of Microsoft Office; specifically, Outlook, Word, Excel, PowerPoint, Access and Visio
- Ability to multi-task, accessing multiple data bases and sites at the same time
- Strong time management and organizational skills
- Ability to plan, organize and prioritize work in multiple situations
- Ability to work within a team setting and participate in accomplishing department goals
- Strong interpersonal, written, and oral communication skills.
- Demonstrated understanding and compliance with HIPAA privacy requirements
- Associates degree or bachelor’s degree in a related discipline, preferred
- One or more professional credentials through AHIMA or AAPC: CPC, CPC-H, CCS, CCS-P, RCC, RHIA, RHIT, CEMC, CPMA or specialty coding credential
- Minimum three years coding and/or auditing experience
- Must be able to travel to client locations as required, which can include occasional overnight travel-typically no more than 4 times per year
Physical and Emotional Requirements:
- Ability to meet HAP’s attendance standards
- Ability to sit for long periods of time while focusing on work
- Ability to maintain calm demeanor and project a positive attitude
- Project and maintain professional demeanor
- Ability to handle stress appropriately
The preceding job description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job.
Healthcare Administrative Partners is an equal opportunity employer and encourages diversity in the workplace.
Interested candidates may send their resume to firstname.lastname@example.org.