Anesthesia Coding QA Specialist III - Remote

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Coders QA and education as part of identified remediation.
• Collaborates with management on development of individual or group performance improvement plans related to billing compliance or coding issues.
• Develops or reviews internal workflow or pathway directives that impact coding and charge capture to include system edits.
• Coders pre-production QA and education.
• Prepares coder content and curriculums and presents coding curriculums.
• Reviews and prepares documentation for educator feedback sessions.
• Provides recommended improvements to documentation templates.
• Prepares and presents coding and regulatory updates.
• Maintains operational workflow pathways and assists coding leads as needed.
• Maintains the coding resources shared library.
• Utilizes knowledge of the revenue cycle and analyzes coding data to assist with the QA selection process.
• Assists in reviews of coding related edits and claim denials.
• Creates tracking and trend reports associated with the initiatives.
• Maintains audit software and database updates.

QUALIFICATIONS

• High school diploma or equivalent.
• Relevant post-secondary education or equivalent hands-on experience in lieu of a degree.
• National certification and minimum of 5 years’ experience in physician coding, anesthesia/pain management, surgery and E/M, and ICD-10, with experience in academic settings.
• National coding certification (AHIMA, AAPC).
• Clinical certification or experience preferred.
• Compliance auditing and anesthesia specialty coding education experience.
• Experience in revenue cycle and claim processing.
• Experience in physician billing compliance preferred.
• Strong presentation and analytical skills.
• Proficient in Excel, Word, and PowerPoint preferred.
• Experience managing multiple clients or projects simultaneously with a high level of attention to detail.
• Assists in supporting teams with analysis and review of documentation for new business.
• Maintains confidentiality of sensitive information concerning patients, physicians, employees, clients, and vendors.
• Ensures compliance with all state, federal, and professional regulations as well as departmental rules, policies, and procedures.
• Maintains specialty certification CEUs, coding updates, and all regulatory or payer guidance.
• Able to communicate professionally with all levels of management.
• Excellent written and oral communication skills are necessary to produce and deliver quality training.
• Excellent technical writing skills for development, implementation, and maintenance of documentation.