Role Description
The purpose of the RCM Coding QA Coordinator position is to provide key data needed to drive continuous improvements within the RCM teams. The QA Specialist will specifically focus on adherence to all USAP compliance policies through process audits, written reports, and analysis of the reports as needed. Responsibilities include:
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Reviewing professional coding and RCM workflow accuracy and quality.
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Assisting Management in routine reviews of policies and procedures.
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Implementing improvement plans as needed.
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Maintaining the highest level of confidentiality regarding auditing results.
This role is expected to require little to no oversight or supervision.
Qualifications
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Excellent verbal and written communication skills.
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Ability to prioritize work.
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Strong background in lifecycle of a claim, collection, and billing knowledge.
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Maintain specialty certification CEUs, coding updates, and all regulatory or payer guidance.
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Experience with Athena IDX or similar system preferred.
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Knowledge of anesthesia billing preferred.
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Analytical skills to summarize audit findings into statistically meaningful reports.
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Strong presentation and written skills.
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Ability to work effectively and independently with RCM staff.
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Must have keyboard skills with knowledge of Microsoft Word, Excel, and PowerPoint.
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Must have a pleasant disposition and high tolerance level for diverse views.
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Ability to adapt to a quick-paced environment that may include changing priorities.
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Strong time management skills.
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Ability to read, write, and speak English.
Requirements
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High School diploma or equivalent.
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National Coding Certification (AHIMA, AAPC).
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Compliance auditing and Specialty Coding Education experience.
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Clinical certification or experience preferred.
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National Certification and minimum of five yearsβ experience in physician coding, Anesthesia/Pain Management, Surgery and E/M, ICD-10.
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Proficiency in MS Office Excel, Word, and PowerPoint.
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Experience in Revenue Cycle and Claim processing.
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Experience in Physician Billing Compliance preferred.
Benefits
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Base pay estimate: $24.13 - $38.65 hourly.
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Eligible for a quarterly bonus based on company and individual performance.
Working Conditions
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Remote working environment.
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Involves frequent contact with professional staff.
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Work may be stressful at times.
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Interaction with others is frequent and often disruptive.