Overview
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The purpose of the RCM Coding QA Coordinator position is to provide key data needed to drive continuous improvements within the RCM teams. The QA Specialist will specifically focus on adherence to all USAP compliance policies. This will be done through process audits, written reports and analysis of the reports as needed. Work products and outputs will include detailed audits and reports to identify process and quality deficiencies, analysis and recommended plans of actions to improve audited processes, as well as to recommend training needs. Responsibilities include reviewing professional coding and RCM workflow accuracy and quality. The RCM Coding QA Specialist will assist Management in routine reviews of policies and procedures, and the implementation of improvement plans as needed. This person has increased knowledge of the coding role and a complete understanding of their work as it relates to the business and consistently meets productivity and quality measures; require little to no oversight or supervision. This role is expected to maintain the highest level of confidentiality regarding auditing results.
At this time, US Anesthesia Partners does not hire candidates residing in California, Hawaii, or Alaska.
The base pay estimate for this role is $24.13 - $38.65 hourly. The final offer will depend on the skills, experience, and qualifications of the selected candidate. This range is for base pay only and does not include bonuses or other compensation. This position is eligible for a quarterly bonus. Bonuses are not guaranteed and are awarded based on company and individual performance.
Job Highlights
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ESSENTIAL DUTIES AND RESPONSIBILITIES (included but not limited to):
- Audit work is primary in coding RCM workflows and secondary responsibilities within the general RCM production teams, to ensure compliance with policies and procedures, expected system functionality usage, and departmental workflows
- Partner with the Education & Development department to assist in development and implementation of education programs based on identified quality issues
- Partner with colleagues to ensure all auditing needs are met
- Act as a Subject Matter Expert (SME) within the auditing team at both a national and regional level
- Complete user and workflow audits in a timely manner, enabling department leadership to use audit data to improve and drive positive changes
- Identify specific individual and department training needs, and assist in ongoing process improvement opportunities through audit analysis
- Review of policy changes, and implementation of those changes, into audit process and reporting
- Maintain up-to-date knowledge of department specific workflows, processes and system configuration updates, by actively partnering with RCM and coding leaders
- Provide feedback to the Education and Development team regarding training materials to ensure they are updated as needed
- Perform ad-hoc audits as needed
- Work with cross-functional teams to improve quality and performance through process improvement initiatives
- Maintain strictest confidentiality
- Participate in QA meetings, and be an active player in achieving annual departmental goals
- Responsible for developing and facilitating monthly reports, including content used for executive summaries
- Perform audits on peers to drive continuous improvements within the QA teams
- Review QA team’s backlog of work, and self-assign work as needed
- Performs other duties, as assigned
REPORTING TO THIS POSITION: No direct reports
Qualifications
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JOB REQUIREMENTS (Knowledge, Skills and Abilities):
- Excellent verbal and written communication skills
- Ability to prioritize work
- Strong background in lifecycle of a claim, collection and billing knowledge is essential
- Maintain specialty certification CEU’s, coding updates and all regulatory or payer guidance
- Experienced with Athena IDX or similar system is preferred
- Knowledge of anesthesia billing preferred
- Analytical skills to summarize audit findings into statistically meaningful reports
- Strong presentation and written skills
- Ability to work effectively and independently with RCM staff
- Must have keyboard skills with knowledge of Microsoft Word, Excel and PowerPoint
- Must have a pleasant disposition and high tolerance level for diverse views, varied skill levels, and positions
- Ability to work independently with little to no supervision
- Ability to adapt to a quick paced environment that may include changing priorities
- Willing and eager to assist team members in achieving overall department productivity requirements
- Strong time management skills
- Ability to read, write, and speak English
EDUCATION/TRAINING/EXPERIENCE:
- High School diploma or equivalent
- National Coding Certification (AHIMA, AAPC)
- Compliance auditing and Specialty Coding Education experience
- Clinical certification or experience preferred
- National Certification and Minimum of five years’ Experience in physician coding, Anesthesia/Pain Management, Surgery and E/M, ICD-10, with experience in Academic settings
- Proficiency in MS Office Excel, Word and Power Point
- Experience in Revenue Cycle and Claim processing
- Experience in Physician Billing Compliance preferred
PHYSICAL REQUIREMENTS:
- Requires prolonged sitting
- Must possess sufficient eye-hand coordination/manual dexterity to operate a keyboard, photocopier, telephone, calculator, and other office equipment
- Required normal range of hearing and eyesight to record, prepare, and communicate appropriate reports and evaluations.
- Requires dexterity to type at least 35 wpm.
WORKING CONDITIONS (environment and safety):
- Remote working environment
- Involves frequent contact with professional staff
- Work may be stressful at times
- Interaction with others is frequent and often disruptive
disclaimer: The above job description has been written to indicate the general nature and level of work performed by employees within this classification. It is not written to be inclusive of all duties, responsibilities and qualifications required of employees assigned to this job.
US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factors.
