QA / Process Specialist - Medical Coding

Responsible for the day-to-day production and quality functions of a team of coders specializing in meeting client production goals and coding accuracy goals. Help supervisor in preparing daily operational reports, provide feedback about the challenges and participate in client interactions and internal stakeholder meetings.

Key Responsibilities :

• Monitors performance of all coding staff using key metrics including, but not limited to daily coding volume, assignments worked, client project deadlines and coding accuracy performance to achieve and maintain a 95% coding quality accuracy rate.
• Escalate Production and QA concerns or roadblocks to the Manager for involvement as needed.
• Work closely with the Training teams to communicate progress across the team to the Manager.
• Reviews both production and quality accuracy reporting and / or system reports on progress for all assigned projects and shares feedback.
• Motivates team members through effective training and coaching to improve quality and professionalism.
• Conducts monthly team meetings and annual performance evaluations with team members.
• Monitors and maintains team attendance records and timesheet for coders.
• Completes any special projects such as full coding audits and other duties as assigned.
• Mentors staff to maximize performance and potential.
• Assist in maintaining and monitoring team member job satisfaction and morale.
• Demonstrated domain expertise in quality processes related to meeting production schedules and the coding of medical diagnoses and treatment practices.
• Deep understanding of both production and quality assurance coding processes and guidelines in HCC risk adjustment coding.
• Analytical and problem-solving skills, and the ability to use data to identify patterns and trends.
• Experience providing training, coaching, and development to team members, as well as providing regular feedback regarding work performance.
• Must possess strong communication skills to convey information across multiple team members with varying skill sets.
• Focuses on continuous improvement by working on projects that enable customers to arrest revenue leakage while complying with the standards.
• Focuses on updating coding skills and knowledge by participating in coding team meetings and educational conferences.
• Extensive knowledge of coding principles and guidelines.
• Extensive knowledge of hospital / technical and professional services reimbursement systems.
• Extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing for professional and technical services.
• Strong managerial, leadership, and interpersonal skills.

Qualifications :

Skills Required

Auditing, Coding, Business Operations, Healthcare, Monitoring