Remote Quality Analyst, Medical Coding & QA

MED-METRIX INTERNATIONAL PH-I, INC.; Metro Manila; On-site; PHP 420,000 - 660,000; Full time

Benefits offered by this job

8-Hour Shifts

Fixed Weekends Off

Day1 HMO with 2 dependents

Group Life Insurance

Medical Cash Allowance

Rice Allowance

Clothing Allowance

Holiday Gift

Bereavement Assistance

Free Lunch Daily

Paid Time Off

Training and Staff Development

Employee Engagement

Internal Mobility

Job summary

Med-Metrix is seeking a Quality Analyst, Coding to collaborate with internal staff in developing improved capabilities in documentation, coding, and compliance. The role reviews coding quality on accounts completed by Medical Coders and ensures adherence to workflows and ethical coding.

Strong knowledge of CPT, ICD-10-CM and HCPCS is required for accurate auditing. The position involves designing and implementing quality coding review programs, communicating findings and recommendations to

Qualifications

• Graduate of any Medical or Allied Medical course or has equivalent work experience.
• Hold AAPC and/or AHIMA certification. CPMA is an advantage.
• At least 3 years of Medical Coding experience
• Proficient with E/M and CPT Procedure coding.
• Minimum of six (6) months experience with exceptional performance in chosen area of quality management Medical Coding – demonstrated HIPAA knowledge required
• Ability to work in a team, adapt to changing responsibilities, shift schedules, procedures and workloads
• Possess strong verbal, written communication, interpersonal skills and analytical skills
• Willingness and flexibility to work extended hours
• Assertive self-starter who can work independently, yet function in a team
• Ability to plan well and prioritize work and maintain calmness under pressure
• Understanding and strict adherence to HIPAA regulations

Responsibilities

• Set team direction, resolves problems and provides guidance to members of own team
• Lead, coach, recognize and develop a team of Employees in all aspects of the job to meet objectives and maintain company culture, polices, goals and procedures
• Administer the Quality Assessment process to ensure all quality standards/targets can be met
• Daily management of all operational processes to ensure that quality, efficiency and productivity standards/targets are met
• Acts as client contact for day-to-day operational issues and staff assignments. Escalate any client concerns immediately to Medical Coding Manager or General Manager.
• Review and analyze reports, records, and data to meet and exceed client and company objectives.
• Collaborate with all workgroups to solve issues that impact internal and external customers.
• Rewarding and disciplining employees; addressing complaints and resolving problems
• Look constantly for development as well as continuous improvement for the entire team.
• Documenting general reports on each team member’s performance and targets as well as ensuring that they exceed the targets.
• Monitors systems to ensure optimal performance.
• Disseminates changes in guidelines and rules; monitor changes in laws, regulations, and policies that impact clinical documentation, reimbursement to assure compliance.
• Foster an environment of teamwork and service excellence within the department.
• Participate in performance improvement activities.
• Assist in the establishment, implementation and maintenance of a formalized review process to ensure compliance with contractual agreements regarding accuracy rates.
• Assist in the creation, monitoring and standardization of company policies and procedures to monitor the success of the data quality management plan, review our and our clients areas of risk, investigate identified issues, report data analyses and take appropriate steps to correct any violations. Make recommendations to ensure the highest compliance rate with the Med-Metrix quality management plan.
• Participate in conference calls/meetings with management and staff to ensure all performance and training recommendations are addressed and improvements suggestions are implemented.
• Assist in new hire training classes, transition periods and refresher trainings as needed.
• Knowledge of, understanding of, and compliance with all Med-Metrix policies and procedures.
• Provide feedback to management concerning possible problems or areas of needed improvement.
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with HIPAA standards.

Skills

Medical coding

HIPAA knowledge

Verbal & written communication

Team collaboration

Analytical skills

Flexibility/extended hours

Education

AAPC or AHIMA certification (CPMA advantageous)

Job description

Med-Metrix is seeking a Quality Analyst, Coding to collaborate with internal staff in developing improved capabilities in documentation, coding, and compliance. The role reviews coding quality on accounts completed by Medical Coders and ensures adherence to workflows and ethical coding.

Strong knowledge of CPT, ICD-10-CM and HCPCS is required for accurate auditing. The position involves designing and implementing quality coding review programs, communicating findings and recommendations to