Quality Assurance Specialist
Fiserv
JavaJenkinsJMeterSDLCSelenium
QA Multispecialty E/m Profee
Guidehouse
full-time
Posted on:
Location Type: Office
Location: Chennai • 🇮🇳 India
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Plans, monitors, direct and evaluate QA production on a daily basis
- Ensures that daily schedules are met and communicates with Director, and Coding Operations if situations occur that hinder meeting deadlines
- If system issues or other emergencies delay QA, implement measures/schedules to return to established schedules at the earliest possible time
- 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
- When applicable, 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
- Answers queries from the quality staff on a day-to-day basis and escalates to the Director of Coding as necessary
- Meets agreed sampling targets and accuracy
- Documentation of QA data on teams of QA/coders and records findings in the QA system (Guide Audit) for reporting to the client
- Guidance and mentorship of coders
- Ensure continuing education is planned, scheduled and completed for all coding/QA teams through the coordination of the US
- Coordinates scheduled quality meetings with the QA and production staff
- Active involvement in project launch sessions along with team leaders to understand the coding process
- Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines
- Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques to effectively apply ICD-9-CM and CPT-4 coding guidelines
Requirements
- Minimum of 4+years of experience on medical coding with E&M IP/OP skill
- Should be certified from AAPC/AHIMA
- Hands on experience in E&M audits
- Must be a Graduate
- Ensure data collection capability in relevant systems and business processes
- Strong analytical, research, and organizational skills required.
- ICD-10-PCS coding systems, ensuring accuracy and compliance with all regulatory and reimbursement requirements
Benefits
- Comprehensive, total rewards package
- Competitive compensation
- Flexible benefits package
- Commitment to creating a diverse and supportive workplace
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
medical codingICD-9-CMCPT-4ICD-10-PCSE&M codingdata abstractionQA documentationcoding guidelinesMS-DRGAPC assignment
Soft skills
analytical skillsresearch skillsorganizational skillscommunication skillsmentorshipproblem-solvingteam coordinationquality assurancedeadline managementleadership
Certifications
AAPC certificationAHIMA certification
