Quality Assurance Leader-Inpatient Medical Coding

GeBBS Healthcare Solutions, Inc.; Navi Mumbai, Hyderabad; In loco; INR 1.200.000 - 1.800.000; Tempo pieno

Descrizione del lavoro

GeBBS Healthcare Solutions, Inc. in Navi Mumbai is seeking a Quality Assurance Leader for IP DRG coding. The role requires 5+ years of medical coding experience in QA or supervisory settings and a strong IP DRG background.

Mandatory Work From Office, with duties including QA reviews, audits, reporting, and adherence to HIPAA. You will develop SOPs and collaborate with client contacts to ensure compliance and data quality across the department.

Competenze

• 5+ years total experience in Medical Coding as QA/SME/Specialist/Supervisor in IP DRG operations or quality teams.
• 6-12 months of documented team lead experience is a plus.
• Strong knowledge of IP DRG and coding guidelines.
• Excellent technical, analytical and communication skills.

Mansioni

• Perform daily coding quality assurance reviews under QA Manager supervision.
• Conduct QA audits using CMS focus lists and RAC/OIG topics as directed.
• Comply with internal and client QA guidelines and review procedures.
• Coordinate with client contacts to review procedures for compliance.
• Prepare weekly QA productivity/progress reports for QA Manager.
• Ensure HIPAA adherence and provide constructive feedback to staff.
• Apply ICD-10-CM guidelines and regulatory requirements in coding reviews.
• Develop SOPs and participate in data quality improvement initiatives.
• Compute and report QA data, spotting trends and patterns.

Conoscenze

IP DRG

Inpatient Coding

Medical Coding

Team Leadership

Client reporting

Formazione

Life Science graduate

CCS/CIC/CPC/COC certification

Descrizione del lavoro

Quality Assurance Leader-Inpatient Medical Coding

Years: 5 - 10

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Job Type: Permanent

Job Description :

Designation : Quality Assurance Leader - IP DRG

Role :

• Work as part of the Quality Assurance Team to perform daily coding quality assurance reviews under the supervision of the QA Manager
• Perform random quality assurance audits utilizing the internal focus target lists developed from CMS, and approved RAC issues, OIG workplan topics, and historical areas of concern, as directed by the QA Manager.
• Comply with the established internal and client-requested QA guidelines.
• Coordination with assigned client contacts to review departmental procedures and ensure compliance.
• Prepare weekly QA productivity and progress reports to QA Manager.
• Ensure strict adherence to HIPAA policies.
• Provide review findings and feedback to coding staff in a constructive manner.
• Complete work assignments within the expected timeframe.
• Apply ICD-10-CM Official Coding Guidelines, Coding Clinic advice, MCE/OCEs, and other regulatory requirements in the coding and review process.
• Develops departmental SOP's as needed. Participates in local and enterprise-wide initiatives to promote data quality and quality improvement.
• Computes and reports statistical QA data in a variety of formats, without computational errors, spotting trends and/or patterns

Skillset and Quaification

• 5+ years total experience in Medical Coding as QA / SME / Specialist / Supervisor / Mentor in IP DRG Coding in Operations or Quality team
• 6-12 months of documented Team Lead experience good to have
• Strong knowledge of IP DRG
• CCS or CIC certification or CPC or COC
• Life Science graduate
• Ability to perform second-level QA audits
• Team management, client reporting & professional email communication skills
• Mandatory Work From Office

Department

Permanent

Open Positions

2

Skills Required

IP DRG, Inpatient Coding , Medical Coding

Location

Education/Qualification

Graduate