QA/Sr. QA - Coding

ensuring accuracy, compliance, and financial soundness through audits, documentation reviews, and by identifying and addressing coding errors, ultimately improving coding practices and processes

Core Responsibilities:

• Auditing and Review:

• Conducting regular audits of coding practices to identify errors and areas for improvement.
• Reviewing medical records and documentation to ensure accuracy and completeness.
• Analyzing coding data to identify trends and patterns.

• Compliance and Regulatory Adherence:

• Ensuring that coding practices adhere to relevant regulations and guidelines (e.g., ICD-10, CPT, HCPCS).
• Staying updated on coding changes and updates.
• Identifying and mitigating potential compliance risks.

• Accuracy and Quality Improvement:

• Identifying and addressing coding errors to improve accuracy.
• Developing and implementing quality assurance policies and procedures.
• Providing feedback and guidance to medical coders to improve performance.
• Participating in quality improvement initiatives.

• Documentation and Reporting:

• Creating and maintaining documentation related to coding audits and quality assurance activities.
• Preparing reports and presentations on coding quality and performance.

• Collaboration and Communication:

• Working with other departments (e.g., billing, compliance) to ensure smooth operations.
• Communicating findings and recommendations to relevant stakeholders.
• Providing training and education to coding staff.

• Data Analysis and Reporting:

• Analyzing coding data to identify trends, patterns, and areas for improvement.
• Preparing reports and presentations on coding quality and performance.

• Ensuring Patient Safety:

• Ensuring that coding practices do not compromise patient safety or confidentiality.

• Healthcare Software Testing:

• Testing healthcare software to ensure accuracy and functionality.