Anesthesia Coding QA Specialist III - Remote

Overview

The Anesthesia Coding QA Specialist III – RCM supports our coding QA process and coder and provider documentation integrity and education. This role provides clinical documentation review to support correct coding and regulatory compliance and is responsible for reviewing professional coding accuracy and quality and educational feedback to coders and providers.

At this time, US Anesthesia Partners does not hire candidates residing in California, Hawaii, or Alaska.

The base pay estimate for this role is $60,800 - $103,400 annually. The final offer will depend on the skills, experience, and qualifications of the selected candidate. This range is for base pay only and does not include bonuses or other compensation. This position is eligible for an annual bonus. Bonuses are not guaranteed and are awarded based on company and individual performance.

Job Highlights

ESSENTIAL DUTIES AND RESPONSIBILITIES: (The ideal candidate must be able to complete all physical requirements of the job with or without a reasonable accommodation)

• Conducts coder 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.
• Conducts coder 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

KNOWLEDGE/SKILLS/ABILITIES (KSAs):

• 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.
• Adherence to safety and HIPAA.
• Maintains specialty certification CEUs, coding updates, and all regulatory or payer guidance.
• Ability 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.
• Travel may be required.

*The physical demands described here are representative of those that may need to be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

• Occasional Standing
• Occasional Walking
• Frequent Sitting
• Frequent hand, finger movement
• Use office equipment (in office or remote)
• Communicate verbally and in writing

US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factors.