Quality Analyst - Facility IP

Guidehouse; Chennai District; On-site; INR 600,000 - 1,000,000; Full time

Job summary

Guidehouse in Chennai seeks a Quality Analyst for Facility IP projects. You will plan, monitor QA production daily, coordinate with the Director of Coding Operations, and implement corrective actions to meet schedules and client obligations.

You will review medical records for ICD-9-CM and CPT-4 coding, ensure proper DRG/APC assignments, and abstract data for optimal reimbursements. MS Excel skills enhance efficiency and reporting.

Qualifications

• Accurate and timely DRG/ICD coding audits with adherence to guidelines.
• Experience in MS-DRG/APC assignments and coding compliance concepts.
• Ability to mentor coders and support education programs.

Responsibilities

• Plans, monitors, direct and evaluate QA production on a daily basis.
• Ensure schedules are met and communicate with leadership about delays.
• Review medical records for accuracy in ICD-9-CM and CPT-4 coding.
• Abstract and compile data for appropriate reimbursements.
• Respond to QA queries and maintain QA documentation in systems.

Skills

IP DRG Auditing

Education

Accredited medical coders (CCA, CCS, CPC, CPC-H)

Tools

Microsoft Excel

Microsoft Word

PowerPoint

Job description

## Quality Analyst - Facility IPApply: IN - Chennai: Full time: Posted Today: 41397**Job Family:**Coding Quality IP (India)**Travel Required:**None**Clearance Required:**None**What You Will Do:*** Plans, monitors, direct and evaluate QA production on a daily basis. Ensures that daily schedules are met and communicates with Director, and Coding Operations if situations occur that hinder meeting deadlines. If system issues or other emergencies delay QA, an implement measures/schedules to return to established schedules at the earliest possible time. This should be done closely with each quality specialist to ensure the needs are met and that satisfy our client requirements.* Responsible for ensuring that the QA communicates a valid, workable schedule for his or her client each week. Accurate, sensible & on-time.\\*\\*If this doesn’t happen properly, it’s the responsibility of the Lead QA Specialist to make it happen promptly.* Review medical record documentation for accuracy in code assignment of the primary/secondary diagnosis and procedures using ICD-9-CM and CPT-4 coding conventions. Sequence the diagnosis and procedures using coding guidelines. When applicable, ensure MS-DRG/APC assignment is accurate. Abstract and compile data from medical records for appropriate optimal/complaint reimbursement for hospital and/or professional charges. This involves reviewing code assignments that are not straightforward or the documentation in the record is inadequate, ambiguous, or unclear for coding purposes.* Answers queries from the quality staff on a day to day basis and escalating to the Director of Coding as necessary.* Meets agreed sampling targets and accuracy.* Keeps abreast of coding guidelines and reimbursement reporting requirements.* Documents QA data on teams of QA/coders and records findings in the QA system (Guide Audit), which will be for reporting to the client, identifying risk areas, development of training and education programs and development/implementation of standardization within the organization. This also involves guidance and mentorship of coders.* Helps to ensure that continuing education is planned, scheduled and completed for all coding/QA teams through the coordination of the US.* Coordinates scheduled quality meetings with the QA and production staff.* Brings identified concerns to Guidehouse’s coding compliance management for discussion.* Project Launch - Active involvement in project launch sessions along with team leaders to understand the coding process.* Have a rotational arrangement and is flexible to work with any given team as assigned.* Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines. -* Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques to effectively apply ICD-9-CM and CPT-4 coding guidelines to inpatient and outpatient diagnoses and procedures.* Assist with research and development and presentation of continuing education programs on areas of specialization.* Assist with special projects as required. Example: Focused audits; client launches, etc.* ***Shall understand and abide by the organizations’ information security policy and protect the confidentiality, integrity and availability of all information assets.**** ***Shall report incidents related to security of information to concerned authorities.*****What You Will Need:**Key Skills: IP DRG AuditingExp. Level: 5+yearsQualifications: Accredited medical coders (CCA, CCS, CPC, CPC-H) with at least 3+ years’ experience.**What Would Be Nice To Have:**Experience is Microsoft Excel, Word and PowerPoint.