Quality Analyst

1 month ago


Manila, National Capital Region, Philippines MiraMed Philippines Group Full time

JOB SUMMARY

The Quality Analyst in Clinical Abstracting is responsible for ensuring the accuracy, completeness, and compliance of clinical data abstracted from medical records. This role involves reviewing and analyzing abstracted data, identifying discrepancies, and providing feedback to abstractors to ensure adherence to clinical guidelines, coding standards, and regulatory requirements. The Quality Analyst works closely with abstractors, coders, and other healthcare professionals to maintain the highest quality of data used for patient care, research, and reporting purposes.

Qualifications & experience

Education: Bachelor's degree in Nursing.Experience: Minimum of 1 year of experience in clinical coding, abstracting, or a related field, with at least 1 year in a quality review or audit role.Licenses/Certifications: Must hold a valid PHRN license.Tasks & responsibilitiesQuality Review: Conduct detailed quality reviews of clinical abstracting work to ensure accuracy, completeness, and compliance with coding guidelines, clinical documentation standards, and regulatory requirements.Compliance Monitoring: Ensure abstracted clinical data aligns with ICD-10, CPT, and other relevant coding standards, as well as payer-specific guidelines.Feedback and Training: Provide constructive feedback to coders and clinical abstractors based on quality review findings. Assist in training sessions to address common errors and improve accuracy.Reporting: Generate and analyze quality reports to identify trends, areas for improvement, and successes. Present findings to management and recommend corrective actions. Reports to their supervisor their productivity status and daily issues.Process Improvement: Participate in process improvement initiatives aimed at enhancing the quality and efficiency of clinical abstracting operations.Documentation: Maintain thorough documentation of quality review activities, including findings, feedback provided, and any corrective actions taken.Collaboration: Work closely with the clinical coding team, compliance department, and other stakeholders to ensure consistent quality and adherence to standards across all abstracted clinical data.BenefitsHMO from Day 1, plus 2 free dependents upon regularizationTemporary work-from-home setupPerformance-based annual appraisalCareer growth opportunitiesSick and vacation leaveEmployee engagement programTraining and development programs
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