Remote IP Quality Reviewer
About The Position
The IP Quality Reviewer reports directly to the Internal Quality Control Director. The role reviews medical record documentation and evaluates coding and abstracting accuracy according to quality review policies and facility guidelines, using ICD-10-CM/PCS and CPT coding classification systems. Patient records are reviewed through facility EMRs, scanning technology, or other established methods. Reviews are entered daily into Guidehouse’s proprietary quality review tracking and trending software, and coder rebuttals are addressed within the timelines specified by quality review policies and procedures. The role also performs related duties as assigned.
Requirements
- At least 5 years of medical coding or review experience.
- High school diploma; relevant experience may be substituted for formal education.
- Must hold an active RHIT, RHIA, CCS, CPC, CIC, or COC credential.
- Must maintain the coding credential while employed by Guidehouse.
- Must pass Guidehouse’s coding competency exam.
Nice To Haves
- Previous audit experience.
Responsibilities
- Access and review medical record documentation.
- Review coding and abstracting accuracy according to quality review policies and facility guidelines.
- Use ICD-10-CM/PCS and CPT coding classification systems during reviews.
- Review patient records through facility EMRs, scanning technology, or other established methods.
- Enter reviews daily into Guidehouse’s proprietary quality review tracking and trending software.
- Respond to coder rebuttals within the timeframes defined by quality review policies and procedures.
- Perform related job duties as assigned.
Benefits
- Medical, prescription, dental, and vision insurance
- Personal and family sick time
- Company-paid holidays
- May be eligible for a discretionary variable incentive bonus
- Parental leave
- 401(k) retirement plan
- Basic life and supplemental life insurance
- Health savings account
- Dental/vision and dependent care flexible spending accounts
- Short-term and long-term disability
- Tuition reimbursement
- Personal development and learning opportunities
- Skills development and certifications
- Employee referral program
- Corporate-sponsored events and community outreach
- Emergency back-up childcare program
- Flexible benefits package
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
