Medical Coding Quality Analyst

2 months ago


Manila, National Capital Region, Philippines MED-METRIX INTERNATIONAL PH-I, INC. Full time

Description

Multi-specialty certified professional coder with knowledge of inpatient and outpatient coding and auditing for various specialties, with preparation and presentation of audit results.

Duties and Responsibilities

Perform coding audits and compliance audits for providers, including physicians and mid-level providersPrepare reports of audits and present audits to internal and external parties as neededComplete accurate application of appropriate coding and documentation guidelines, including but not limited to, E&M and surgery documentation guidelines, CCI guidelines, CPT/HCPCS coding guidelines, and specialty association guidanceComplete coding audits for our copartners' coding WQWork with any offsite auditorsEvaluate and report on the overall quality of physician documentation that supports selected codes most specifically but not inclusive of medical necessityAdhere to local and national coverage determinations, and CCI and payer specific editing rulesEnsure appropriate documentation and coding of split/shared services, teaching physician guidelines and any client specific quality assessment programsCompile, trend, analyze and report on all findings that do not meet all of the guidelines listed aboveUse, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standardsMaintain a professional attitude Other duties as assigned by the management team RequirementsCPC or CCS coding certification required from AHIMA or AAPC High School graduate or equivalentMinimum 1 year of coding and/or auditing experienceKnowledge of Microsoft Word, Outlook, ExcelMust be able to use job-related software Working ConditionsPhysical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hearMental Demands: The employee must be able to follow directions, collaborate with others, and handle stressWork Environment: The noise level in the work environment is usually minimal Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, (including pregnancy, gender identity, and sexual orientation), parental status, national origin, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
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