Clinical Operations QA Specialist

Job not on LinkedIn

🔥 2 minutes ago

🇺🇸 United States – Remote

💵 $33 - $34 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Clinical Operations

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Reveleer

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

⚕️ Healthcare Insurance

☁️ SaaS

Healthcare • Healthcare Insurance • SaaS

Reveleer is a healthcare technology company that specializes in providing an end-to-end platform for value-based care. Their platform leverages artificial intelligence to automate tasks, improve efficiency, and enhance patient care by consolidating risk adjustment and quality improvement workflows. Reveleer helps healthcare organizations streamline their operations through intelligent data acquisition, enhancing productivity and ensuring accurate reimbursement. With a focus on healthcare intelligence, Reveleer integrates with HIEs and EHR systems to improve care delivery and capture relevant diagnoses. They have a significant presence in the healthcare industry, working with various health plans to maximize their performance and patient outcomes.

📋 Description

• Complete overread of chases for coders in production • Support the initial QA process during onboarding • Communicate coding error trends to the Training and QA team • Assist in creating action plans to mitigate QA discrepancies • Assist coders in resolving coding queries based on Reveleer Coding Guidelines, AHA Coding Clinics, and CMS Coders Guidance on Medical Review • Create and maintain quality control activities, including bi-monthly performance checks and monthly quality assurance reviews • Track QA scores and ensure corrections are completed promptly • Identify outliers requiring retraining and set action plans • Conduct one-on-one or group teaching in coordination with the training team • Pull reports to analyze error trends and present findings to the internal team • Collaborate and consult with QA teams to ensure adherence to policies and procedures • Provide additional support as necessary to meet customer obligations

🎯 Requirements

• Must have a professional coding certificate through AHIMA/AAPC • Minimum of 5 years coding experience • Specific knowledge of Medicare and Commercial Risk Adjustment, such as Hierarchical Condition Category (HCC) • Strong computer skills • High-speed internet access at home • Commitment to confidentiality of patient health information • Professional, articulate, and able to work independently • Skilled in Microsoft Office applications, including Excel, Word, and PowerPoint • Knowledgeable in Adobe Pro • Ability to collaborate effectively with QA teams and staff at all levels

🏖️ Benefits

• Medical, Dental and Vision benefits • 401k with Employer Match • Generous PTO plan • Competitive salary

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