Pro Fee Quality Team Lead

🔥 8 hours ago

🇺🇸 United States – Remote

💵 $74k - $124k / year

⏰ Full Time

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Guidehouse

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2018

🏥 Healthcare

🎖️ Defense

📦 Logistics

💰 Grant on 2023-02

Healthcare • Defense • Logistics

Guidehouse is a global consultancy offering advisory, digital, and managed services across commercial and public sectors. It is purpose-built to support industries such as national security, financial services, healthcare, energy, and infrastructure. Guidehouse collaborates with leaders to navigate complexity and drives transformational changes that impact the future. Their expertise spans data analytics, digital technologies, risk management, and more, with a strong emphasis on sustainability and innovation.

📋 Description

• Assist with onboarding and training pro fee reviewers on resource tools, facility-guideline drives, OneNote, Replicon, education portal, policies and procedures, and client-specific policies • Create client review training workflows and associated training materials as needed • Collaborate with coding operations leaders and oversee pro fee QA pre-bill assignments • Assist with reviewer connectivity for new or existing clients and troubleshoot with the review team • Collaborate with onshore and offshore coding leadership to update and distribute the pro fee review assignment sheet weekly • Review entire patient record documentation for audited dates of service to validate code and abstract-data accuracy • Validate applicable code elements • Complete monthly coding quality reviews for the required number of accounts per coder • Identify abstracting, ICD-10-CM, CPT, modifier, and HCPCS coding errors • Run coder productivity reports from facility systems or GuideAudit production, or pull random sample accounts from completed coding spreadsheets

🎯 Requirements

• Must hold one of the following active credentials: CPC, COC, CPMA, RHIT, RHIA, CCS, CIC or COC • Must have a high school diploma/GED • Relevant experience accepted in lieu of a degree • Must maintain coding credentials while employed by Guidehouse • Must pass Guidehouse coding competency exam • Must have at least 8 years of pro fee coding or review experience • Abide by all client policies and procedures • Abide by all Guidehouse policies and procedures • Ability to work with Microsoft Office, Excel, computer programs, and company-specific programs • Auditing experience is preferred • Previous leadership experience • BS/BA is preferred

🏖️ Benefits

• Medical, Rx, Dental & Vision Insurance • Personal and Family Sick Time & Company Paid Holidays • Position may be eligible for a discretionary variable incentive bonus • Parental Leave • 401(k) Retirement Plan • Basic Life & Supplemental Life • Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts • Short-Term & Long-Term Disability • Tuition Reimbursement, Personal Development & Learning Opportunities • Skills Development & Certifications • Employee Referral Program • Corporate Sponsored Events & Community Outreach • Emergency Back-Up Childcare Program • Flexible benefits package • Competitive compensation