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Cotiviti · 2 days ago
QA I Coding Operations
United States
Full-time
Remote
Entry Level
$24/hr - $31/hr
1+ years exp
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Responsibilities
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.
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.
Qualification
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Required
High School diploma required, Bachelor's degree preferred.
Coding certification required through AAPC or AHIMA (CPC, CRC, CCS, etc.).
Expertise in medical record auditing, particularly in HCC mapped diagnosis coding.
Minimum of one to three years HCC coding experience.
Demonstrated greater than 95% accuracy in HCC coding work.
Adherence to official coding guidelines, coding clinic determinations, client specific coding guidelines, CMS and other regulatory compliance guidelines and mandates.
Ability to read and understand medical record documentation.
Must be able to identify trends in coding and documentation errors, to include over and under-coding.
Excellent written and verbal skills to include coaching and interpersonal skills.
Strong knowledge of medical terminology and anatomy and physiology.
Skilled in organization and customer service.
Computer and technology literate.
Analytical and problem-solving skills.
Ability to manage and meet deadlines.
Must remain flexible to provide assistance in any emergent situations and/or projects.
Must participate in any required training.
Must abide by all HIPAA and associated patient confidentiality requirements.
Preferred
Clinical background preferred, but not required.
Benefits
Medical insurance
Dental insurance
Vision insurance
Disability insurance
Life insurance
401(K) savings plans
Paid family leave
9 paid holidays per year
17-27 days of Paid Time Off (PTO) per year
Company
Cotiviti
Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics, helping to ensure the quality and sustainability of how healthcare is delivered in the United States.
5,001-10,000 employees
Funding
Current Stage
Late StageLeadership Team
Adam Gilbert
Director, Interoperability Operations and Partnerships
Chris McIntyre
Sr. Program Manager, RQNC Operations
Recent News
2024-04-07
Company data provided by crunchbase
