3 Rhia Jobs

Greetings from Access healthcare services We are hiring SQ AVP for coding (Quality) Experience: - 17+ years Designation: - SQ AVP for coding (Quality) Location :- Chennai Specialty: - HCC & Multi-specialty Key Qualifications & Skills: 18+ years of experience in Healthcare RCM, Risk Adjustment (HCC) Coding, and Quality Assurance. Deep knowledge of ICD-10-CM, CMS-HCC Model, Medicare Advantage, and Risk Adjustment Guidelines. Strong experience in HCC audit frameworks, accuracy improvement, and compliance enforcement. Certified in AAPC or AHIMA certifications (CRC, CPC, CCS, RHIT, or RHIA preferred). Expertise in AI-powered coding audit tools, automation, and process digitization is a plus. Strong leadership and stakeholder management experience, with the ability to influence change and drive quality initiatives. Data-driven mindset with experience in Quality Metrics, Root Cause Analysis (RCA), and Lean Six Sigma methodologies. Eligibility Criteria : Six sigma Black Belt/Master Black Belt certified from reputed institutions like ISI, ASQ, Benchmark, KPMG etc., along with project experience. Overall, 18-20 years of overall experience in a BPO/KPO/Health care services with minimum 15 years experience in Service Quality (Quality Assurance/Transactional quality). Minimum 5-6 years for Core HCC Coding experience is required. Certified in AAPC or AHIMA certifications (CRC, CPC, CCS, RHIT, or RHIA preferred). Competency Requirement (Technical & Behavioral): Quality Assurance & Compliance Oversee end-to-end quality audits for HCC coding across multiple vendors and in-house teams. Ensure 100% compliance with CMS Risk Adjustment guidelines, ICD-10 coding standards, and HIPAA regulations. Implement and enforce HCC coding best practices to minimize missed diagnoses, over-coding, and under-coding. Lead external and internal audit programs to improve accuracy and compliance. Process Optimization & Error Reduction Establish and enhance quality control frameworks to improve coding accuracy and efficiency. Drive initiatives to reduce error rates, improve coding precision, and enhance productivity. Implement AI-driven audit solutions (e.g., automated coding reviews, real-time QA tools) to optimize efficiency. Competency Requirement (Technical & Behavioral): Quality Assurance & Compliance Oversee end-to-end quality audits for HCC coding across multiple vendors and in-house teams. Ensure 100% compliance with CMS Risk Adjustment guidelines, ICD-10 coding standards, and HIPAA regulations. Implement and enforce HCC coding best practices to minimize missed diagnoses, over-coding, and under-coding. Lead external and internal audit programs to improve accuracy and compliance. Process Optimization & Error Reduction Establish and enhance quality control frameworks to improve coding accuracy and efficiency. Drive initiatives to reduce error rates, improve coding precision, and enhance productivity. Implement AI-driven audit solutions (e.g., automated coding reviews, real-time QA tools) to optimize efficiency. Monitor HCC Accuracy KPIs (Missed Error Rate, Extra Error Rate, Inter-Rater Reliability). Data-Driven Insights & Performance Improvement Utilize data analytics to identify trends in HCC coding accuracy, compliance risks, and vendor performance. Develop dashboards and reporting mechanisms for leadership visibility on quality performance metrics. Collaborate with Operations & Training teams to address coding discrepancies and drive corrective action plans. Team Leadership & Training Lead and mentor a team of QA Managers, Auditors, and Trainers across multiple locations. Develop quality training programs for coders to enhance their proficiency and ensure coding consistency. Foster a culture of continuous improvement, compliance, and performance excellence. If interested to apply, email your resume to praveen.t@accesshealthcare.com Reach out 9655581000

Greetings from Access healthcare services We are hiring SQ AVP for coding (Quality) Experience: - 17+ years Designation: - SQ AVP for coding (Quality) Location :- Chennai Specialty: - HCC & Multi-specialty Key Qualifications & Skills: 18+ years of experience in Healthcare RCM, Risk Adjustment (HCC) Coding, and Quality Assurance. Deep knowledge of ICD-10-CM, CMS-HCC Model, Medicare Advantage, and Risk Adjustment Guidelines. Strong experience in HCC audit frameworks, accuracy improvement, and compliance enforcement. Certified in AAPC or AHIMA certifications (CRC, CPC, CCS, RHIT, or RHIA preferred). Expertise in AI-powered coding audit tools, automation, and process digitization is a plus. Strong leadership and stakeholder management experience, with the ability to influence change and drive quality initiatives. Data-driven mindset with experience in Quality Metrics, Root Cause Analysis (RCA), and Lean Six Sigma methodologies. Eligibility Criteria : Six sigma Black Belt/Master Black Belt certified from reputed institutions like ISI, ASQ, Benchmark, KPMG etc., along with project experience. Overall, 18-20 years of overall experience in a BPO/KPO/Health care services with minimum 15 years experience in Service Quality (Quality Assurance/Transactional quality). Minimum 5-6 years for Core HCC Coding experience is required. Certified in AAPC or AHIMA certifications (CRC, CPC, CCS, RHIT, or RHIA preferred). Competency Requirement (Technical & Behavioral): Quality Assurance & Compliance Oversee end-to-end quality audits for HCC coding across multiple vendors and in-house teams. Ensure 100% compliance with CMS Risk Adjustment guidelines, ICD-10 coding standards, and HIPAA regulations. Implement and enforce HCC coding best practices to minimize missed diagnoses, over-coding, and under-coding. Lead external and internal audit programs to improve accuracy and compliance. Process Optimization & Error Reduction Establish and enhance quality control frameworks to improve coding accuracy and efficiency. Drive initiatives to reduce error rates, improve coding precision, and enhance productivity. Implement AI-driven audit solutions (e.g., automated coding reviews, real-time QA tools) to optimize efficiency. Competency Requirement (Technical & Behavioral): Quality Assurance & Compliance Oversee end-to-end quality audits for HCC coding across multiple vendors and in-house teams. Ensure 100% compliance with CMS Risk Adjustment guidelines, ICD-10 coding standards, and HIPAA regulations. Implement and enforce HCC coding best practices to minimize missed diagnoses, over-coding, and under-coding. Lead external and internal audit programs to improve accuracy and compliance. Process Optimization & Error Reduction Establish and enhance quality control frameworks to improve coding accuracy and efficiency. Drive initiatives to reduce error rates, improve coding precision, and enhance productivity. Implement AI-driven audit solutions (e.g., automated coding reviews, real-time QA tools) to optimize efficiency. Monitor HCC Accuracy KPIs (Missed Error Rate, Extra Error Rate, Inter-Rater Reliability). Data-Driven Insights & Performance Improvement Utilize data analytics to identify trends in HCC coding accuracy, compliance risks, and vendor performance. Develop dashboards and reporting mechanisms for leadership visibility on quality performance metrics. Collaborate with Operations & Training teams to address coding discrepancies and drive corrective action plans. Team Leadership & Training Lead and mentor a team of QA Managers, Auditors, and Trainers across multiple locations. Develop quality training programs for coders to enhance their proficiency and ensure coding consistency. Foster a culture of continuous improvement, compliance, and performance excellence. If interested to apply, email your resume to snithin.sai.@accesshealthcare.com ; aarthipriya.b@accesshealthcare.com

Medical Coding Associate Job Description: Qualification Requirements Current Coding Certification (CPC, CPC-P, CPC-H, CPC-I, CRC, CCS, RHIT, RHIA etc.) through AAPC and/or AHIMA Minimum of 2+ years coding experience with specific knowledge of Medicare and Commercial Risk Adjustment such as Hierarchical Condition category (HCC). Additional experience in facility (OPPS/IPPS) coding experience is preferred Additional experience in Health Plan Risk Adjustment Data Validation Audit (RADV) experience is preferred Experience and Skills Ability to work independently in a fast-paced remote environment with minimal supervision and guidance Ability to interact with management personnel Possess strong organizational skills and attention to detail Ability to adapt to changing priorities while managing a wide range of projects Adaptive and flexible to new ideas and change Advanced knowledge of medical terminology, anatomy, and pharmacology Advanced skills utilizing official coding resources for research and problem solving Advanced skills and knowledge of computers, use of required software to perform job functions Excellent written and communication skills and the ability to explain complex information Demonstrate strong analytical skills, organizational skills, attention to detail, excellent verbal and written communication skills Good understanding of audits strategies and framework Knowledge of basic Quality tools Knowledge on Audit Sampling frameworks and analysis Performance Analysis Interpret and implement Quality Assurance Standards and procedures Role & responsibilities Shift timings - Rotational shift Thanks & Regards Lalitha 9281037167 sri.lalitha@spsoftglobal.com