Anesthesia Coding QA Specialist III

This is a fully remote position, open to applicants in Alaska, +2 more states.

📋 Description

• Performs coder quality assurance and educational activities as part of identified remediation efforts.

• Works closely with management to develop individual or group performance enhancement plans focused on billing compliance or coding challenges.

• Creates or evaluates internal workflow or pathway directives that influence coding and charge capture, including system edits.

• Executes coder pre-production quality assurance and educational tasks.

• Designs and delivers coder content and curriculums, presenting coding training materials.

• Reviews and prepares documentation for feedback sessions with educators.

• Suggests enhancements to documentation templates.

• Prepares and shares updates on coding and regulatory matters.

• Keeps operational workflow pathways up to date and supports coding leads as necessary.

• Manages the coding resources shared library.

• Applies knowledge of the revenue cycle and analyzes coding data to aid in the quality assurance selection process.

• Assists in reviewing coding-related edits and claim denials.

• Develops tracking and trend reports related to various initiatives.

• Oversees audit software and ensures database updates are maintained.

⛳️ Requirements

• High school diploma or equivalent is required.

• Relevant post-secondary education or equivalent practical experience in lieu of a degree is necessary.

• National certification and a minimum of 5 years’ experience in physician coding, anesthesia/pain management, surgery and E/M, and ICD-10, particularly in academic environments.

• National coding certification (AHIMA, AAPC) is essential.

• Clinical certification or experience is preferred.

• Experience in compliance auditing and anesthesia specialty coding education is required.

• Familiarity with revenue cycle and claim processing is necessary.

• Experience in physician billing compliance is preferred.

• Strong presentation and analytical capabilities are a must.

• Proficiency in Excel, Word, and PowerPoint is preferred.

• Ability to manage multiple clients or projects at once while maintaining a high level of detail is essential.

• Aids teams in analyzing and reviewing documentation for new business opportunities.

• Maintains confidentiality regarding sensitive information about patients, physicians, employees, clients, and vendors.

• Ensures adherence to all state, federal, and professional regulations, as well as departmental rules, policies, and procedures.

• Complies with safety standards and HIPAA regulations.

• Keeps up with specialty certification CEUs, coding updates, and all regulatory or payer guidance.

• Capable of communicating professionally with all management levels.

• Excellent written and oral communication skills are necessary for producing and delivering effective training.

• Strong technical writing skills are needed for the development, implementation, and upkeep of documentation.

• Travel may be necessary.

🏝️ Benefits

• This position is eligible for an annual bonus, which is not guaranteed and is awarded based on individual and company performance.