QA/Process Specialist - Medical Coding

Hsmconsulting; Bengaluru; On-site; INR 700,000 - 1,200,000; Full time

Job summary

Huron is seeking a skilled coding professional to lead a team of coders responsible for meeting client production and coding accuracy goals. You will monitor performance metrics, provide feedback, and collaborate with training teams to drive quality and adherence to guidelines.

The role requires strong communication, attention to detail, and deep knowledge of EM OP coding guidelines. You will mentor staff, conduct evaluations, and participate in client interactions and internal stakeholder

Qualifications

• Graduate or Post Graduate in Life Science, Pharmacy, Physiotherapy, Zoology or Microbiology.
• 5+ years of industry experience.
• CPC - Certified Coding Professional or CCS - Certified Coding Specialist.

Responsibilities

• Monitors performance of coding staff using metrics to achieve 95% coding quality.
• Escalates production and QA concerns to the Manager.
• Reviews production/quality reports and shares feedback.
• Mentors staff and conducts monthly team meetings and annual evaluations.
• Maintains attendance records and time sheets for coders.
• Completes special projects and coding audits as assigned.

Skills

Communication

Attention to detail

Problem solving

Education

Life Science / Pharmacy / Physiotherapy / Zoology / Microbiology

Job description

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes.

Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients.

Joining the Huron team means you'll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise.

Join our team as the expert you are now and create your future.

Responsible for the day-to-day production and quality functions of a team of coders specializing in meeting client production goals and coding accuracy goals. Help supervisor in preparing daily operational reports, provide feedback about the challenges and participates in the client interactions and internal stakeholder meetings. Excellent communication skills, attention to detail, and strong technical and problem solving skills are essential aspects of this role.

JOB DETAILS:

• Monitors performance of all coding staff using key metrics including, but not limited to daily coding volume, assignments worked, client project deadlines and coding accuracy performance to achieve and maintain a 95% coding quality accuracy rate.
• Escalate Production and QA concerns or roadblocks to the Manager for involvement as needed. Work closely with the Training teams members to communicate progress across the Team to the Manager.
• Reviews both production and quality accuracy reporting and/or system reports on progress for all assigned projects and share feedback
• Motivates team members through effective training and coaching to improve quality and professionalism on work assignments. Conducts monthly team meetings and annual performance evaluations with team members.
• Monitors and maintains team attendance records and time sheet for coders.
• Completes any special projects, such as full coding audit, and other duties as assigned in a timely manner.
• Mentors staff to maximize performance and potential.
• Assist in maintaining and monitoring team member job satisfaction and morale.
• Demonstrated domain expertise in quality process related to meeting production schedules and the coding of medical diagnoses and treatment practices
• Deep understanding of both the production and quality assurance coding process and guidelines in EM OP coding.
• Analytical and problem solving skills, and the ability to use data to identify patterns and trends.
• Experience providing training, coaching, and development to team members, as well as providing regular feedback regarding work performance
• Must possess strong communication skills to convey information across multiple team members with varying skill sets.
• Maintains a high degree of professional and ethical standards
• Focuses on continuous improvement by working on projects that enable customers to arrest revenue leakage while complying with the standards.
• Focuses on updating coding skills and knowledge by participating in coding team meetings and educational conferences
• Extensive knowledge of coding principles and guidelines.
• Extensive knowledge of hospital/technical and professional services reimbursement systems.
• Extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing for professional and technical services.
• Strong managerial, leadership, and interpersonal skills.

QUALIFICATIONS:

• Graduate or Post Graduate in Life Science, Pharmacy, Physiotherapy, Zoology, Microbiology discipline
• 5+ years of industry experience
• CPC - Certified Coding Professional or
• CCS - Certified Coding Specialist

Position Level

Associate

Country

India