Job
Description
As a candidate for the position, you should possess excellent domain expertise and process knowledge in RCM for Facility/Hospital settings. Your knowledge should include familiarity with ICD-10-CM, ICD-10-PCS coding guidelines, UHDDS guidelines, Principal Diagnosis, CCs and MCCs, DRG selection and validation, POS indicators, Query Process, MS DRG, APR DRG, SOI, ROM. Additionally, understanding of medical record documentation guidelines and federal compliance guidelines in an Inpatient Hospital setting is essential. You should also be well-versed in quality processes in Coding. Your skills should encompass strong interpersonal, good communication, presentation, and analytical skills. A quality-focused and data-driven approach is crucial. You must have the ability to manage a team size of 40-50 employees and possess an analytical approach to problem-solving. In terms of behavior, you should exhibit discipline, a positive attitude, punctuality, and a collaborative approach as a team player. The ideal candidate should have experience in IP DRG Coding with at least one relevant certification from AAPC or AHIMA (CCS and CIC preferred). Additionally, having 1-2 years of experience in team management, exposure to coding audit functions and mechanisms, developing training contents, working on quality improvement projects, and familiarity with coding workflows and prominent EMR(s) and CAC systems are highly desirable. You should also be well-versed in the utilization of CMS and industry guidelines for IP DRG coding. Your key responsibilities will include: - Supervising and managing a team of 40-50 QAs and QALs - Creating an inspiring team environment with an open communication culture - Designing QA capacity planning as per project scope requirement - Delegating tasks and setting deadlines - Managing the quality of multiple IP DRG Coding projects - Analyzing internal and client quality data and suggesting remedial action plans - Implementing quality control mechanisms as per client quality process - Ensuring effective implementation of the organization's Quality Management System - Monitoring team performance and reporting on metrics - Performing random audits of auditors - Conducting Root Cause Analysis (RCA) on audit observations, identifying knowledge gaps, and developing action plans with quality leads and operation managers - Providing regular feedback to the Training team to update content - Discovering training needs and providing coaching to QAs and Trainers - Listening to team members' feedback and resolving any issues or conflicts - Recognizing high performance and rewarding accomplishments Please note that the above is a detailed description of the role and responsibilities associated with the position. As a candidate for the position, you should possess excellent domain expertise and process knowledge in RCM for Facility/Hospital settings. Your knowledge should include familiarity with ICD-10-CM, ICD-10-PCS coding guidelines, UHDDS guidelines, Principal Diagnosis, CCs and MCCs, DRG selection and validation, POS indicators, Query Process, MS DRG, APR DRG, SOI, ROM. Additionally, understanding of medical record documentation guidelines and federal compliance guidelines in an Inpatient Hospital setting is essential. You should also be well-versed in quality processes in Coding. Your skills should encompass strong interpersonal, good communication, presentation, and analytical skills. A quality-focused and data-driven approach is crucial. You must have the ability to manage a team size of 40-50 employees and possess an analytical approach to problem-solving. In terms of behavior, you should exhibit discipline, a positive attitude, punctuality, and a collaborative approach as a team player. The ideal candidate should have experience in IP DRG Coding with at least one relevant certification from AAPC or AHIMA (CCS and CIC preferred). Additionally, having 1-2 years of experience in team management, exposure to coding audit functions and mechanisms, developing training contents, working on quality improvement projects, and familiarity with coding workflows and prominent EMR(s) and CAC systems are highly desirable. You should also be well-versed in the utilization of CMS and industry guidelines for IP DRG coding. Your key responsibilities will include: - Supervising and managing a team of 40-50 QAs and QALs - Creating an inspiring team environment with an open communication culture - Designing QA capacity planning as per project scope requirement - Delegating tasks and setting deadlines - Managing the quality of multiple IP DRG Coding projects - Analyzing internal and client quality data and suggesting remedial action plans - Implementing quality control mechanisms as per client quality process - Ensuring effective implementation of the organization's Quality Management System - Monitoring team performance and reporting on metrics - Performing random audits of auditors - Conducting Root Cause Analysis (RC
