Outpatient Coding Quality Associate
About The Position
R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. Our Outpatient Coding Quality Associate will be responsible for reviewing clinical documentation and diagnostic results as appropriate (i.e., to extract data and apply appropriate ICD-10-CM, HCPCS and CPT-4 codes for billing, review and correct billing edits, internal and external reporting, research, and regulatory compliance). Under the direction of the Coding Leadership Team, the successful candidate must be able to accurately code conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting.
Requirements
- Three (3) years' experience in Outpatient coding
- Credentials: CCS, COC, CPC, RHIA or RHIT
Nice To Haves
- Experience with edits and denials
- Strong communication skills
- Proficiency with standard office systems
- Ability to prioritize shifting workloads to meet department and revenue cycle goals.
Responsibilities
- Review outpatient coded records for completeness and accuracy, meeting department standards for high productivity and at least 95% accuracy in professional services coding.
- Identify coding errors, research applicable AMA, payer, and regulatory guidelines, and communicate timely corrections and audit findings to coders.
- Perform retrospective coding quality audits and help resolve local coding issues to improve overall coding consistency and compliance.
- Serve as a coding subject matter expert and resource for coding staff and other departments, including support with education based on audit results.
- Maintain current knowledge of official coding conventions, documentation requirements, government regulations, and commercial payer guidelines.
- Support reporting and performance improvement efforts by helping analyze audit data, identify workflow or audit tool improvements, and assist with testing updates as needed.
Benefits
- Competitive benefits package
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
