Landmark Health

  • Medical Coding QA Specialist

    Job Locations US-Remote
    Posted Date 2 weeks ago(11/21/2019 2:30 PM)
    Category
    Coding
    Type
    Temporary Full-Time
    Job ID
    2019-3683
  • Overview

    Landmark Health is a high growth, entrepreneurial organization committed to improving healthcare for patients with the most serious and complex medical needs wherever they reside and whenever they need it.

    Our clinical model is transformative – it represents a landmark in the evolution of our nation’s healthcare system.

    Turning this vision into reality requires exceptional people who share our unwavering commitment to the patients we serve.

    Do you want to make a difference? Join us today!

    Responsibilities

    This position plays a key role on the Landmark Health team by ensuring the accuracy, integrity, quality and compliance of coded patient data through Quality Assurance chart reviews; identifying opportunities for quality improvement, education and training for coding staff.  This position will also be a key contributor in both internal and external coding audit activities.  The Coding QA Specialist must have excellent attention to detail and a comprehensive knowledge of outpatient guidelines for ICD.10, CPT, HCPCS, HCC/Risk adjustment, AHA Coding Clinic and other available resources.

     

    Audit, Education and Training Responsibilities:

    • Function as the subject matter expert for medical coding regulation, guidelines, updates and industry best practice.
    • Adhere to the highest standard of integrity and compliance for medical coding and QA in the organization.
    • Perform quality assurance on both aggregate coded data and individual encounter data to determine accuracy of coded data utilizing established coding conventions, guidelines and regulations.
    • Give ongoing feedback and regularly cadenced quality scores to coders and Coding Leadership
    • Tracking and reporting of internal quality assurance scores to team leads, supervisors, managers, Coding Director, compliance and others as need.
    • Reviewing, responding, tracking of Health Plan coding reviews, QC, audits. Comparing HP findings and recommendations with the documentation and medical coding in the chart. Develop preliminary response and report results to Coding Leadership.
    • Work in partnership with Coding Leadership team to identify trends and create coder education materials
    • Monitor updates of coding guidelines, industry trends and best practice – alert Coding Leadership of these updates and suggest topics of education.
    • Review and monitor coder queries to providers ensuring strict adherence to industry standards including, but not limited to, AHIMA Practice Brief for Compliant Queries, AHA Coding Clinic recommendations for query.
    • Collaborate with Coding Leadership team to identify trends and create action plans based on them
    • Participate in QA of contracted coding/HRA vendors.
    • Develop and cultivate positive relations with Medical Coders and Coding Specialists. Foster a positive culture and environment of support and continuous improvement throughout the QA process.

    SUPERVISORY

    Medical Coding QA Specialists will report to the Sr. Director of Medical Coding with dotted line reporting to the Coding Manager. Medical Coding QA Specialists will not have direct reports but will have opportunity to grow their QA career as Landmark health grows.

    Qualifications

    Required:

    • Coding Credential from AHIMA or AAPC – at least one of the following: CPC, CCS, CCS-P, RHIT, or RHIA.
    • 1 year coding QA experience. 
    • Ability to travel for work related reasons 10% of the time.

    Preferred:

    • 2+ year experience coding QA and audit experience
    • Credential from AAPC or AHIMA in coding QA and/or audit
    • Experience in QA Risk Adjustment coding and auditing
    • Experience in outpatient Fee For Service coding
    • Experience developing and presenting coder education
    • Experience with a remote work environment               

    COMPETENCIES

    • Thorough knowledge of anatomy, physiology, pharmacology and medical terminology
    • Abide by AHIMA and/or AAPC coding Code of Ethics
    • Compliance with Landmark policies, procedures
    • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
    • Communicate professionally with Landmark coders, compliance team, Coding Leadership and Landmark Health Leadership
    • Clear communication skills both individual and group
    • Ability to develop internal and recommend external coder training and education.

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