LifePoint Health- Health Support Center
****Remote Work Opportunity****
Pacific Medical Data Solutions, a company of LifePoint Health, is a rapidly growing nationwide revenue cycle management services provider that has been offering high quality medical billing services since 2004. Headquartered in the Denver Tech Center, we offer a rewarding work environment with career advancement opportunities while maintaining a small company, employee-focused atmosphere.
We are currently seeking a Quality Analyst. This remote-based position will spend the majority of the time auditing coders, educating coders, and working on various projects that involve coding and education. You would be working in a team environment with guidance from the Audit Supervisor and Audit Manager. This position also works closely with the Centralized Coding Unit and PMDS vendor partners.
The Quality Analyst will perform Evaluation and Management coding, procedure, ICD-10 and HCPC quality reviews as well as other projects related to physician coding compliance. Demonstrates a thorough understanding of complex coding, and reimbursement, as they relate to physician practices and clinic settings. Keeps informed regarding current coding regulations, professional standards and company/department policies and procedures and effectively applies this knowledge.
RESPONSIBILITIES
- Seeking Certified auditor with a minimum of 5 years' Pro-Fee coding experience.
- Experience with Provider Based and Rural Health preferred, not required.
- Apply appropriate coding classification standards and guidelines to medical record documentation for accurate coding.
- Perform quality assessment of records, including verification of medical record documentation (both electronic and handwritten).
- Perform quality assessments of coders completed work to validate standards are met.
- Educate coders and other staff on appropriate coding guidelines.
- Responsible for researching errors or missing documentation from medical records in order to provide accurate coding processes.
- Abstract and assign the appropriate ICD-10, HCPCS/CPT codes; including Level I & Level II modifiers as appropriate for all diagnosis and procedures performed in outpatient and inpatient settings.
- Assist in the development and ongoing maintenance of processes and procedures for each assigned client revolving around system use, billing/coding rules, and client specific guidelines.
- Manage time effectively to meet all required deadlines and timeframes for client and department needs.
- Collaborate in a team environment with the Department Manager and other staff on a regular basis.
- Ensure compliance with all relevant regulations, standards, and laws.
