QA Engineer

• 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

QA Multispecialty E/m Profee

Assistant Manager – QA/QC

Principal, Quality Engineering

Quality Assurance Specialist

Senior Quality Test Engineer