QA / Sr. QA - Coding

In medical coding QA, responsibilities include  ensuring accuracy, compliance, and financial soundness through audits, documentation reviews, and by identifying and addressing coding errors, ultimately improving coding practices and processes . Here's a more detailed breakdown of QA responsibilities in medical coding :

Core Responsibilities :

• Auditing and Review :
• Conducting regular audits of coding practices to identify errors and areas for improvement.
• Reviewing medical records and documentation to ensure accuracy and completeness.
• Analyzing coding data to identify trends and patterns.
• Compliance and Regulatory Adherence :
• Ensuring that coding practices adhere to relevant regulations and guidelines (e.g., ICD-10, CPT, HCPCS).
• Staying updated on coding changes and updates.
• Identifying and mitigating potential compliance risks.
• Accuracy and Quality Improvement :
• Identifying and addressing coding errors to improve accuracy.
• Developing and implementing quality assurance policies and procedures.
• Providing feedback and guidance to medical coders to improve performance.
• Participating in quality improvement initiatives.
• Documentation and Reporting :
• Creating and maintaining documentation related to coding audits and quality assurance activities.
• Preparing reports and presentations on coding quality and performance.
• Collaboration and Communication :
• Working with other departments (e.g., billing, compliance) to ensure smooth operations.
• Communicating findings and recommendations to relevant stakeholders.
• Providing training and education to coding staff.
• Data Analysis and Reporting :
• Analyzing coding data to identify trends, patterns, and areas for improvement.
• Preparing reports and presentations on coding quality and performance.
• Ensuring Patient Safety :
• Ensuring that coding practices do not compromise patient safety or confidentiality.
• Healthcare Software Testing :
• Testing healthcare software to ensure accuracy and functionality.

Skills Required

Cpc, HCC, Medical Coding