Quality Analyst - Facility IP
Core
Plans, monitors, directs, and evaluates QA production for medical record coding accuracy and reimbursement optimization.
Role type
Senior Quality Analyst (Medical Coding)
Builds
Accurate ICD-9-CM and CPT-4 code assignments and MS-DRG/APC assignments for hospital and professional charges.
Domain
Healthcare / Medical Coding
Required skills
ICD-9-CM coding, CPT-4 coding, MS-DRG assignment, APC assignment, medical record abstraction, audit sampling, coding guidelines knowledge, reimbursement reporting, data documentation, mentorship of coders
Preferred skills
Microsoft Excel, Microsoft Word, Microsoft PowerPoint
Technologies
Guide Audit, ICD-9-CM, CPT-4
Responsibilities
Plan and monitor daily QA production schedules; Review medical records for accurate diagnosis and procedure coding; Sequence diagnoses and procedures using coding guidelines; Abstract and compile data for optimal reimbursement; Answer queries from quality staff and escalate to Director of Coding; Meet agreed sampling targets and accuracy; Document QA data in the QA system; Coordinate quality meetings with QA and production staff; Guide and mentor coders; Assist with project launches and special projects like focused audits.
Seniority
Senior, hands-on IC
