Profee Coding Quality Specialist
New
C
CorroHealthHealthcare
Must reside in the United StatesFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- Minimum 3 years of Profee coding experience and/or auditing in an acute care facility or multispecialty clinics.
- Required Skills
- Microsoft Excel
Requirements
- Minimum 3 years of Profee coding and/or auditing experience in an acute care facility or multispecialty clinics.
- Recognized coding credential from AHIMA or AAPC (e.g., CPC or CCS).
- RHIA or RHIT credentials may also be considered.
- Strong analytical skills with the ability to identify and resolve coding quality issues.
- Proficiency in Microsoft Office applications including Word and Excel.
- Ability to navigate diverse electronic medical record (EMR) environments.
- Strong verbal and written communication skills.
- Ability to work independently with minimal supervision.
- Ability to prioritize workload and meet deadlines.
- Experience with telecommuting strongly preferred.
- Experience with outpatient (OP) facility billing and APC assignment preferred.
Responsibilities
- Perform complex retrospective analysis of medical records to identify coding and billing errors according to AHA, CMS, and AMA guidelines.
- Analyze audit findings to identify root causes of errors and prevent reoccurrence.
- Conduct second-level review of diagnosis, procedure, and billing codes to ensure regulatory compliance and optimal reimbursement.
- Provide technical support, training, and feedback to internal coding staff regarding compliance and regulatory provisions.
- Monitor coder progress to ensure a minimum accuracy of 95% and review percentages close to 10%.
- Identify and resolve coding quality issues in a timely manner.
- Research and respond to inquiries regarding compliance, coding denials, and billable services.
- Maintain professional coding credentials and current knowledge of reimbursement methodologies.
- Provide status reports to senior management as requested.
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