Position: Quality Assurance Specialist Coding
Location: Aurangabad ( Sambhaji Nagar), Maharashtra
Key Responsibilities
- Conduct daily coding quality assurance (QA) reviews as a member of the QA team, under the guidance of the QA Manager.
- Perform random QA audits using internal focus lists, derived from CMS, RAC-approved issues, OIG work plan topics, and historical risk areas, as directed by the QA Manager.
- Adhere to established internal and client-specific QA guidelines at all times.
- Coordinate with designated client contacts to review departmental procedures and verify compliance.
- Prepare and present weekly QA productivity and progress reports to the QA Manager.
- Maintain strict compliance with HIPAA and all applicable privacy regulations.
- Deliver review findings and provide constructive feedback to coding staff.
- Complete assigned work within prescribed deadlines.
- Apply established guidelines and regulatory requirements (ICD-10-CM Coding Guidelines, Coding Clinic advice, MCE/OCEs) during all coding and review activities.
- Develop departmental Standard Operating Procedures (SOPs) as needed; participate in data quality and improvement initiatives across local and enterprise settings.
- Calculate and report statistical QA data accurately, identifying trends and patterns effectively.
- Provide backend support as needed.
- Work with management to identify and implement improvements to operational procedures for better efficiency and quality outcomes.
Required Skills & Knowledge
- Graduate with a minimum of 5 years of experience in medical coding, specifically focused on surgery coding.
- Currently serving in a QA, Senior Coder, or equivalent capacity and eligible to step into a Team Leader role.
- Willingness and readiness to work from the office.
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