ProFee Coding QA Mentor/Trainer

R1 RCM Inc. is a leading provider of technology-enabled revenue cycle management services which transform and solve challenges across health systems, hospitals and physician practices.

Our mission is to be the one trusted partner to manage revenue, so providers and patients can focus on what matters most. Our priority is to always do what is best for our clients, patients and each other. With our proven and scalable operating model, we complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience.

As our ProFee Coding QA Mentor/Trainer, you will help mentor new coders as well as perform internal quality reviews aimed at identifying areas of improvement and education. Every day you will perform quality reviews, improve education materials, and assist with production where needed. To thrive in this role you must have at least two full years of coding experience in the Professional Coding environment and a deep understanding of CPT/HCPCS, Revenue Codes, ICD-10 PCS, ICD-10 Diagnosis codes & modifiers. 

Here’s what you will experience working as a Pro Fee Coding QA Mentor/Trainer: 

• Perform quality reviews: 

• Review a monthly sampling of accounts to identify opportunities for education and support to the coding staff 

• Review audits performed by our global quality review team to ensure alignment across departments 

• Provide detailed rationale and supporting references for recommendations and findings. 

• Identification of trends for reporting to management and creation of reports for submission 

• Provide continuing education, training, guidance, and support to maintain elite standards. 

• Calibration sessions between Operations, Quality, and Training to ensure knowledge alignment with client needs and specifications. 

• Researching, escalating, and responding to coder support questions as triaged by leadership. 

• Mentor new hires: 

• Communication with new auditing staff and leadership during prebill and ramp phases 

• Prescribed progress milestone review 

• Weekly reporting to management 

• Updating of processes on as needed basis and contribution of learning materials as needed 

• Production coding when available 

To be successful in this role you must have:

• One of the following certifications: CPC, COC, CCS RHIT, RHIA, or LPN 

• Experience in professional coding, preferred experience in both professional and facility coding  

• Strong knowledge of CMS guidelines, Ambulatory Payment Classification (APC), Outpatient Prospective Payment System (OPPS), National Correct Coding Initiative (NCCI) edits, and Inpatient Prospective Payment System (IPPS). 

• Experience working with coding software such as Epic, Cerner, Meditech, and 3M 360. 

Desired Qualifications 

• Excellent communication skills, presentation skills, and proficiency in MS Excel & PowerPoint. 

• Proficiency in medical terminologies and disease processes. 

• Strong attention to detail. 

• Ability to work independently and as part of a team. 

• At least 1 year of experience as a quality auditor is preferred.