Quality Analyst - IPDRG Coding

Savista; Chennai District; On-site; INR 600,000 - 900,000; Full time

Job summary

Savista seeks a Quality Analyst to audit medical coding charts within TAT, track quality percentages, and ensure HIPAA compliance. Strong IP DRG, ICD-10 CM coding, and physician query knowledge are essential. Familiarity with payer updates and policy alignment is required.

The role includes conducting regular quality meetings, preparing reports for the ops team, educating coders, and maintaining comprehensive quality documentation and confidential PHI handling as per HIPAA and company policy.

Qualifications

• Minimum 3 years of work experience in IP DRG.
• Foundational knowledge in ICD-10 CM coding, PCS & physician query.
• Certified CPC/COC/CCS accreditation preferred.

Responsibilities

• Audit medical coding charts within the set TAT on a regular basis.
• Monitor internal & external quality percentages for projects.
• Ensure HIPAA compliance and follow company quality policies.
• Conduct daily/weekly/monthly quality meetings.
• Share quality reports with the operations team in a timely manner.
• Provide education and feedback to coders on a regular basis.
• Maintain accurate quality reports and documentation.

Skills

Team player

Excellent communication

Root cause analysis

Adaptability

Disciplined and systematic approach

Education

CPC/COC/CCS certification (AAPC/AHIMA)

Tools

MS Office

Excel

Job description

Greetings from Savista!!

JOB RESPONIBILITY

a. Quality Analysis responsibilities

• To audit the medical coding chart within TAT basis regularly.
• To aware of internal & External quality percentage of respective projects.
• To aware of client updated up to date.
• To aware of quality percentage for Both Live & Schedule audit.
• Prioritize the Audit pending work and any other audit related work received from ops team.
• Escalated any difficulty process or deviation in quality to report management in a timely manner.
• To conduct quality Meeting daily/weekly and monthly.
• To aware of HIPPA compliance.
• To aware of company quality policies and client quality policies.
• To share quality report to ops team with timely.
• To provide proper education and feed back to coder in regular basis.
• To maintain the quality report

b. Performance Standards:

• The number of audit charges to analyze will meet or exceed departmental productivity and quality standards.
• To meet all KPI parameters in Quality department.

c. Client Policy and Procedure:

• Maintain an up-to-date personal folder containing updated quality reports documentation; policy e-mails; payer updates; minutes and handouts from monthly meetings; letter templates with file addresses.
• Consistently apply current policy and procedure to all Quality analysis.
• Advise management when additional policies may be needed to support analysis activities
• Maintain strict confidentiality in accordance with HIPAA regulations and Company policy.
• Any patient private health information (PHI) must not be divulged on any account except to payers that need the information to process the claim for payment.

CANDIDATE PROFILE

• Minimum 3 years of work experience in IP DRG. Value addition if they already worked in Quality department with relevant attributes and skills.
• Profound foundational knowledge in ICD-10 CM coding, PCS & physician query
• Should hold either CPC or COC or CCS certifications accredited by AAPC or AHIMA
• Strong anatomy & physiology knowledge
• Team player.
• Good Root Cause Analysis capabilities.
• Excel and MS Office skills.
• Excellent Communication & task orientation.
• Adaptability to work in different shifts, teams and roles.
• Disciplined and systematic approach to daily work.

Work mode:

Work from Office.

Regards,

TA - Team