Analyst designing and implementing strategies for organizational growth focusing on digital trends. Contributing to the strategic alignment for sustainability and profitability.
About the role
- Quality Analyst overseeing coding quality and audits at Guidehouse. Involves planning, reviewing medical records, and ensuring accuracy for optimal reimbursement.
Responsibilities
- Plans, monitors, direct and evaluate QA production daily
- Ensures that daily schedules are met and communicate with Director, and Coding Operations
- Review medical record documentation for accuracy in code assignment of the primary/secondary diagnosis and procedures using ICD-9-CM and CPT-4 coding conventions
- Sequence the diagnosis and procedures using coding guidelines
- Ensure MS-DRG/APC assignment is accurate
- Abstract and compile data from medical records for appropriate optimal/complaint reimbursement for hospital and/or professional charges
- Documents of QA data on teams of QA/coders and records findings in the QA system (Guide Audit)
- Coordinates scheduled quality meetings with the QA and production staff
Requirements
- Minimum 3+ years of experience in IP DRG coding specialty
- 1 year of experience in IP auditing
- Mandatory certifications like CIC, CCS, CPC
- Must be a Graduate
- Good communication and analytical skills are required
- ICD-10-PCS coding systems, ensuring accuracy and compliance with all regulatory and reimbursement requirements
Benefits
- comprehensive, total rewards package that includes competitive compensation
- flexible benefits package
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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