Clinical Operations QA Specialist
New
R
ReveleerClinical risk adjustment
Location: United States; RemoteFull-TimeSenior
Salary33 - 34 USD per hour
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Job Details
- Experience
- Minimum of 5 years coding experience
- Required Skills
- Microsoft ExcelPowerPoint
Requirements
- Hold a professional coding certificate through AHIMA or AAPC.
- Have a minimum of 5 years of coding experience.
- Have specific knowledge of Medicare and Commercial Risk Adjustment, such as Hierarchical Condition Category (HCC).
- Have strong computer skills and high-speed internet access at home.
- Maintain confidentiality of patient health information.
- Be able to work independently.
- Be skilled with Microsoft Office applications, including Excel, Word, and PowerPoint.
- Be knowledgeable in Adobe Pro.
Responsibilities
- Complete overreads of production coder chases and support initial QA during onboarding.
- Communicate coding error trends to the Training and QA team and help develop action plans to address discrepancies.
- Assist coders with queries using Reveleer Coding Guidelines, AHA Coding Clinics, and CMS Coders Guidance on Medical Review.
- Conduct bi-monthly performance quality checks and monthly quality assurance reviews.
- Track QA scores and ensure corrections are completed on time.
- Identify outliers for retraining and coordinate one-on-one or group teaching with the training team.
- Pull reports to analyze error trends and present findings to the internal team.
- Collaborate with QA teams to support adherence to policies and procedures.
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