Coding Quality Specialist

Job not on LinkedIn

🕒 July 17

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

CorroHealth

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

☁️ SaaS

Healthcare • Healthcare Insurance • SaaS

CorroHealth is a leading provider of clinically led healthcare analytics and technology-driven solutions, focused on enhancing the financial performance of hospitals and health systems. Their integrated solutions and advanced technologies aim to optimize the entire revenue cycle, offering services such as revenue cycle management, clinical documentation, medical coding, and denials management. With a commitment to improving financial health through intelligent technology and expert guidance, CorroHealth addresses complex payer-provider relationships and supports efficient healthcare operations.

📋 Description

• Performs complex retrospective analysis of medical record documentation to identify coding and billing errors and inconsistencies according to guidelines of the AHA, CMS, AMA, Clinic Coding Clinic and CPT Assistant. • Analyzes audit findings to identify potential root causes of coding errors and prevent their reoccurrence. • Provides second –level review of diagnosis, procedure and billing codes to ensure compliance with legal and procedural policies that ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices. • Research, analyze and respond to inquiries regarding compliance, inappropriate coding, denials and billable services. • Provides technical support and feedback training to internal coding staff regarding coding compliance, documentation, regulatory provisions, third part payer requirements, medical necessity requirements. • Protects the privacy and confidentiality of patient health and client information. • Follows the Standards of Ethical Coding as set forth by AHIMA and adheres to official coding guidelines and compliance practices. • Suggests physician query opportunities query Physicians based upon documentation and clinical needs. • Prepares deliverables for the coders as required. • Reports work time and work productions in a timely and accurate manner. • Communicates with coworkers in an open and respectful manner which promotes teamwork and knowledge sharing. • Provides schedule of planned work activities, events and sites, and any changes to same to management and appropriate staff. • Maintenance of professional coding credentials and knowledge of coding, reimbursement methodologies and compliance issues through education. • Monitors the ongoing progress and success of each coder. • Maintains QA percentages within two internal quality goals; 1) overall minimum coder accuracy of 95% and 2) QA review percentages as close to 10% as possible. • Identifies and resolves coding quality problems or issues in a timely manner. • Maintains a continual knowledge of problems or issues that could affect coding quality levels. • Assists in the design of systems to help improve coder productivity and assist in improving accuracy of coding. • Provides monthly reports. • Participates in corporate training and meetings. • Provides status reports to senior manager as requested. • Aligns conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct and supports the Company’s Ethics and Compliance Program. • Interprets coding guidelines for accurate code assignment. • Identifies the importance of documentation on code assignment and the subsequent reimbursement impact. • Complies with all internal policies and procedures.

🎯 Requirements

• Minimum 3 years of Profee coding experience and/or auditing in an acute care facility or multispecialty clinics • Recognized coding credential from AHIMA or AAPC; and RHIA or RHIT may also be considered • Strong analytical skills • Familiarity with hospital outpatient billing processes • Understanding of hospital APC assignment and associated coding and documentation • Coding Certification -- preferred (CPC or CCS) • Proficient in Microsoft Office applications including Word and Excel • Ability to navigate in a variety of EMR environments and review hand-written charts • Strong verbal and written communication skills • Ability to prioritize workload, meet deadlines and maintain a high level of quality and accuracy

🏖️ Benefits

• Health insurance • Professional development opportunities