FirstBank Jobs

QA I Coding Operations Job Locations

US-Remote ID

2024-13007

Category Coding  

Position Type Full-Time Overview

The QA I, Clinical Ops position works with the Coding and Clinical Validation Audit team focused on risk coding. The QA position monitors and reports on the accuracy of all code captures on a % of all images of their assigned coders. This position also answers all questions for their coders through the Questions Queue or via email. QA is also responsible for assisting in the remediation for their coders which include full image review of all images coded prior to release to ensure accuracy of image, for any coder below project benchmark.

Responsibilities

The QA I, Clinical Ops position works with the Coding and Clinical Validation Audit team focused on risk coding. The QA position monitors and reports on the accuracy of all code captures on a % of all images of their assigned coders. This position also answers all questions for their coders through the Questions Queue or via email. QA is also responsible for assisting in the remediation for their coders which include full image review of all images coded prior to release to ensure accuracy of image, for any coder below project benchmark. Provides Quality Assurance feedback by working as a liaison between Coder I, Coder II and the Team Lead to ensure 95% coding accuracy. Reviews a defined percentage of the Coder I and Coder II work to ensure a 95% accuracy rate is maintained. This is for new hires as well as existing staff. * 100% of the work is reviewed for a new Hire until they have a consistent 95% accuracy rate * No more than 10% of the work is reviewed for Coder I, Coder II once they have tested at 95% quality. * Completes image review for proper HCC mapped diagnosis coding from various chart types (physician, Facility, non - Facility). Ensures that the highest level of HCC mapped diagnosis code was utilized in each date of service reviewed and documentation of findings in company data storage program. Professionally communicates finds, errors, and any suggestions to all staff in order to facilitate on-going communications and efficient department operations. * Completes internal audits as necessary to support quality accuracy. * Responds to questions via the 'Questions Queue' for individual coders. * Reviews internal system reports on quality of work for all assigned Clinical Coder Specialists. These reports are reviewed daily, weekly, monthly, quarterly and yearly as needed. * Communicate quality issues and trends to the Team lead, Coding Manager and Training Manager. * Recommend additional training based on results of the quality audit for those Coder I and Coder II where they fall behind the 95% accuracy rate. * Develop an action plan in collaboration with the Team Lead and Manager as needed with regard to improvement in the quality of work for a Coder I or II and reports progress to the Team Lead. * Regular interaction with other Cotiviti staff, such as training and quality assurance to facilitate clarification and/or training on coding results. * May have occasional special projects that will entail a full coding review. * Professionally communicates finds, errors, and any suggestions to Team Lead to facilitate on-going communications and efficient department operations as part of a continuous improvement process.. * Utilize Cotiviti training tools and coding library for questions. * Completes all responsibilities as outlined on annual Performance Plan. * Completes all special projects and other duties as assigned. * Must be able to perform duties with or without reasonable accommodation.

Qualifications

• High School diploma required, Bachelor's degree preferred.
• Clinica l background... For full info follow application link.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities