Coding QC Analyst

Recruiting Solutions; Columbia (SC); Hybrid; USD 75,000 - 95,000; Full time

Benefits offered by this job

Comprehensive employee benefits

Flexible schedule

Continuous professional development opportunities

Job summary

A leading healthcare organization is seeking a Coding QC Analyst responsible for overseeing quality control reviews and training. The ideal candidate should have over 10 years of medical coding experience and current coding credentials from AHIMA or AAPC. You will ensure coding accuracy and compliance while managing quality metrics. This role offers a flexible schedule and remote work options, providing a supportive work environment with opportunities for professional growth.

Qualifications

• 10+ years of medical coding experience, including inpatient and outpatient.
• 3+ years of experience in Medical Collections and claim reviews.
• Advanced coding competency in ICD-10, CPT, and HCPCS.

Responsibilities

• Oversee daily coding quality control review team.
• Coordinate training activities of quality control analysts.
• Perform data quality reviews on coding assignments.
• Document findings of analysis and prepare reports.

Skills

Coding competency in ICD-10-CM

Medical coding experience

Quality control reviews

Medical collections

Education

Current AHIMA or AAPC credentials

Job description

Coding QC Analyst Responsibilities and Metrics

Are you looking for your next challenge? The Virtual Business Office Associates is the perfect balance of a diverse and growing workforce that still feels like home. If you are a Coding Professional with extensive experience, come join our best in KLAS Extended Business Office today!

Hiring remotely from: FL, GA, TX, NC, SC, VA, KY, AL.

FLSA Status: Exempt

What’s in it for you:

• Add to your portfolio by joining our fast-paced, exciting, diverse and inclusive work environment
• Endless growth opportunities and continuous professional development
• You’ll support one of the largest professional services firms in the world, with access to cutting edge automation and AI technologies to enhance your workday experience
• A permanent position with our company that offers stability and growth opportunities
• A flexible schedule that allows you to enjoy a work life balance, and leave early on Friday’s
• Comprehensive employee benefits

What you’ll do:

• Oversees daily coding quality control review team and coding trainer to ensure quality remains at or above 95% accuracy for the coding team both onshore and offshore.
• Directs and coordinates all training activities of quality control analyst and coding trainer engaged in reviews of coding activities
• Performs data quality reviews on inpatient/outpatient encounters to validate the ICD-10-CM, ICD-10- PCS, CPT, and HCPCS Level II code and modifier assignments, DRG/APC group appropriateness.
• Oversee monthly quality reviews of implemented policies Ensures that all turnaround times and quality measurements are met
• Keeps abreast of coding guidelines and reimbursement reporting requirements.
• Documents findings of analysis. Prepares reports and suggest recommendations of implementation of new systems, procedures, or organizational changes.
• Identifies areas of weakness and communicates recommendations on changes and improvement to Assistant Director, Manager and Team Leads and Coding teams.

What you’ll need:

• Current AHIMA credentials (i.e. CCS, CCS-P) or AAPC credentials (i.e. COC, CIC, CPC, CPC-H) required and maintained
• 10+ years of medical coding experience (facility and/or consulting) to include both inpatient and outpatient and quality control reviews in an acute care setting
• 3+ years of experience in Medical Collections, back-end A/R, and claim review in which denial follow up was worked
• Demonstrate advanced to expert level coding competency in ICD-10-CM, ICD-10-PCS, CPT-4, HCPCS and Coding Modifiers and displays advanced competency of Inpatient/Outpatient coding guidelines and Diagnosis Related Group (DRG)/Ambulatory Payment Category (APC) assignment