Senior Quality Assurance Specialist

3 days ago

Cagayan de Oro, Northern Mindanao, Philippines beBeeCoding Full time ₱657,810 - ₱1,061,700
Job Overview

The Quality Assurance Specialist, Coding is responsible for collaborating with internal teams to develop and improve coding capabilities. This role assesses and reviews the overall quality of coding on accounts completed by Medical Coders.

This position requires advanced knowledge of professional coding standards including CPT, ICD-10-CM and HCPCS. The ideal candidate will have a strong understanding of quality management principles and be able to administer quality assessment processes effectively.

Duties and Responsibilities
  • Team Leadership

Set direction for team members and resolve problems as needed.

Quality Management

Administer quality assessment processes to ensure all quality standards are met.

Operational Management

Manage daily operational processes to ensure quality, efficiency and productivity standards are met.

Client Communication

Act as client contact for day-to-day operational issues and staff assignments.

Reporting and Analysis

Review and analyze reports, records and data to meet and exceed client and company objectives.

Collaboration and Problem Solving

Collaborate with workgroups to resolve issues impacting internal and external customers.

Employee Development

Reward and discipline employees as needed, addressing complaints and resolving problems.

Continuous Improvement

Continuously look for ways to improve the team's performance and efficiency.

Schedule Management

Ensure team members follow their schedules properly.

Complaint Handling

Handle complaints, questions and queries from clients and team members.

Performance Monitoring

Document team member performance and targets, ensuring they exceed targets.

System Monitoring

Monitor systems to ensure optimal performance.

Policies and Procedures

Disseminate changes in guidelines and rules, monitor changes in laws and regulations impacting clinical documentation and reimbursement.

Team Environment

Foster an environment of teamwork and service excellence within the department.

Performance Improvement

Participate in performance improvement activities.

Data Quality Management

Assist in establishing, implementing and maintaining a formalized review process to ensure compliance with contractual agreements regarding accuracy rates.

Policies and Procedures Standardization

Assist in creating, monitoring and standardizing company policies and procedures to monitor the success of the data quality management plan, review areas of risk, investigate identified issues and report data analyses.

New Hire Training

Assist in new hire training classes, transition periods and refresher trainings as needed.

Policy Compliance

Knowledge of, understanding of, and compliance with all relevant policies and procedures.

Confidentiality

Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.

In this role, you will have the opportunity to make a meaningful impact on our organization's success while developing your skills and expertise in quality assurance and coding.

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