Remote IP Quality Reviewer

Guidehouse; United States; Remote; USD 65,000 - 108,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

401(k)

Paid Holidays

Parental Leave

Tuition Reimbursement

Learning Opportunities

Employee Referral Program

Corporate Sponsored Events

Job summary

Guidehouse in the United States is seeking a Medical Coding Reviewer to report directly to the Internal Quality Control Director. You will access and review medical record documentation, coding and abstracting accuracy using ICD-10 CM/PCS and CPT, ensuring compliance with quality review policies and facility guidelines.

The role involves reviewing records via EMR, scanning technology, or other established methods.

Qualifications

• 5+ years of medical coding or review experience.
• High School Diploma (Relevant experience may be substituted for formal education).
• Must hold one of active credentials: RHIT, RHIA, CCS, CPC, CIC or COC.
• Must maintain coding credential while employed by Guidehouse.
• Must pass Guidehouse coding competency exam.

Responsibilities

• Report directly to the Internal Quality Control Director and review medical record documentation, coding and abstracting accuracy per policy using ICD-10 CM/PCS and CPT.
• Review patient records via EMR, scanning technology or established methods.
• Enter reviews daily into Guidehouse quality review tracking software and respond to coder rebuttals promptly as defined in policies.
• Perform any related duties as assigned.

Skills

Medical coding experience

Education

High School Diploma

Job description

Job Family: General Coding

Travel Required: None

Clearance Required: None

What You Will Do:

• report directly to the Internal Quality Control Director and will be responsible for accessing and reviewing the medical record documentation, coding and abstracting accuracy as defined in quality review policies and facility guidelines utilizing ICD-10 CM/PCS and CPT coding classification systems.
• Review of patient records will be conducted via facility EMR, scanning technology or other established method.
• All reviews will be entered daily into Guidehouse proprietary quality review tracking and trending software and will respond to coder rebuttals in a timely manner (timeline defined in quality review policies and procedures).
• This position will perform any and all related job duties as assigned.

What You Will Need:

• 5+ years of medical coding or review experience
• High School Diploma (Relevant experience may be substituted for formal education)
• Must hold one of the following active credentials: RHIT, RHIA, CCS, CPC, CIC or COC.
• Must maintain coding credential while employed by Guidehouse.
• Must pass Guidehouse coding competency exam.

What Would Be Nice To Have:

• Previous audit experience

The annual salary range for this position is $65,000.00-$108,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer:

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care
• Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program

Guidehouse is a global AI-led professional services firm delivering advisory, technology, and managed services to the commercial and government sectors. With an integrated business technology approach, Guidehouse drives efficiency and resilience in the healthcare, financial services, energy, infrastructure, and national security markets. Built to help clients across industries outwit complexity, the firm brings together approximately 18,000 professionals to achieve lasting impact and shape a meaningful future.

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [e-mail]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or [e-mail]. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.

guidehouse.com