Anesthesia Coding QA Specialist III

This is a fully remote position, open to applicants in Texas.

📋 Description

• Assists in our coding quality assurance process while ensuring the integrity and education of coder and provider documentation.

• Conducts reviews of clinical documentation to support accurate coding and adherence to regulatory standards.

• Responsible for assessing the accuracy and quality of professional coding and providing educational feedback to coders and providers.

• Engages in coder quality assurance and educational initiatives as part of identified remediation efforts.

• Works alongside management to develop performance improvement plans for individuals or groups concerning billing compliance or coding challenges.

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

• Performs pre-production quality assurance and educational activities for coders.

• Develops coding content and curricula, delivering presentations on coding topics.

• Reviews and prepares documentation for sessions providing feedback to educators.

• Suggests enhancements to documentation templates.

• Prepares and shares updates on coding and regulatory matters.

• Maintains operational workflow pathways and provides support to coding leads when necessary.

• Oversees the coding resources shared library.

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

• Assists in the review of coding-related edits and claim denials.

• Develops tracking and trend reports related to initiatives.

• Keeps audit software and database updates current.

⛳️ Requirements

• High school diploma or equivalent qualification.

• Relevant post-secondary education or comparable hands-on experience in place of a degree.

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

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

• Clinical certification or relevant experience is preferred.

• Experience in compliance auditing and specialized education in anesthesia coding.

• Familiarity with the revenue cycle and claim processing is essential.

• Experience in physician billing compliance is preferred.

• Strong presentation and analytical capabilities are necessary.

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

• Experience managing multiple clients or projects concurrently with a keen attention to detail.

• Ability to maintain confidentiality regarding sensitive patient, physician, employee, client, and vendor information.

• Capacity to communicate professionally across all management levels.

• Excellent written and oral communication skills are vital for delivering high-quality training.

• Strong technical writing abilities for the development, implementation, and upkeep of documentation.

• Travel may be required.

🏝️ Benefits

• This role is eligible for an annual bonus, which is not guaranteed and is contingent upon both company and individual performance.