Remote Pro Fee Quality Reviewer

US104 Guidehouse Managed Services LLC; Washington (District of Columbia); Hybrid; USD 56,000 - 94,000; Full time

Benefits offered by this job

Medical, Rx, Dental & Vision Insurance

401(k) Retirement Plan

Paid Holidays

Bonus potential

Tuition Reimbursement

Skills Development & Certifications

Employee Referral Program

Community Outreach

Job summary

Guidehouse is seeking a Coding Quality Reviewer to audit medical record documentation and coding accuracy across the coding team. You will work under the Pro Fee Quality Review Supervisor, applying ICD-10-CM, CPT, and HCPCS standards in multiple specialties.

Required are a high school diploma, US citizenship, and a coding credential (RHIA, RHIT, CCS, CPC, CIC, COC) with 5+ years of coding or review experience; Excel skills are a plus.

Qualifications

• High school diploma or equivalent; US citizenship required.
• Must hold one coding credential (RHIA, RHIT, CCS, CPC, CIC, COC).
• 5+ years of coding or review experience.

Responsibilities

• Review medical record documentation, coding and abstracting accuracy using ICD-10-CM, CPT and HCPCS.
• Ensure quality across specialties including Orthopedics, Transplant, Neuro/Spine, Neuro/Cranial, Trauma, Maxillofacial, Dental Radiology, Interventional Radiology, Injection and Infusion, Radiation Oncology.
• Report to the Pro Fee Quality Review Supervisor and align with client policies.

Skills

ICD-10-CM

CPT

HCPCS

Excel

Independent work

Education

High School Diploma or Equivalent

RHIA

RHIT

CCS

CPC

CIC

COC

Tools

Excel

Job description

Job Family: General Coding Travel Required: None Clearance Required: None

What You Will Do

The Coding Quality Reviewer shall report directly to the Pro Fee Quality Review Supervisor and will be responsible for accessing and reviewing the medical record documentation, coding and abstracting accuracy as performed by the Guidehouse coding team by utilizing ICD-10 CM, CPT and HCPCS coding classification systems. Looking for specific experience in the areas below: Orthopedics Transplant Neuro/Spine Neuro/Cranial Trauma Maxillofacial Dental Radiology Interventional Radiology Injection and Infusion Radiation Oncology

What You Will Need

High school diploma or equivalent US Citizenship Must hold one of the following credentials: (RHIA, RHIT, CCS, CPC, CIC, COC) Must maintain coding credential while employed by Guidehouse 5+ years of coding or review experience Abide by all client policies and procedures

What Would Be Nice To Have

Excellent verbal and written Communication Skills High level of productivity Advanced Coding Skills, ICD-10-CM and CPT Ability to work independently Strong working knowledge of Protected Health Information Experience with Excel

Salary

The annual salary range for this position is $56,000.00-$94,000.00. 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

About Guidehouse

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 is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties. Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee. 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.com