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Jorie AI • Oak Brook, Illinois, United States
Salary: $28 - $32 / hour
Role & seniority: Medical Coding Multi Specialty QA Specialist (CPC Certified); mid-level
Stack/tools: ICD-10, CPT, HCPCS coding guidelines; payer and governmental policies; medical billing software; EHR systems
Audit coded charts across multi-specialty practice and provide feedback/education based on results
Develop educational materials and conduct internal coding audits; identify and implement process improvements
Produce coding, financial, and operational reports; communicate findings to maximize revenue and reduce denials; monitor utilization improvements
AAPC CPC certification; 4+ years in multi-specialty coding (physician practice/clinic); 3+ years QA/improvement experience
Advanced knowledge of ICD-10, CPT, HCPCS; familiarity with payer/government policies
Proficiency with medical billing software and EHR systems; strong attention to detail; collaborative teamwork
About the Role The Medical Coding Multi Specialty QA Specialist (CPC Certified) is responsible for the quality assurance of our internal coding team and performs quality audits to ensure compliance with coding guidelines, as well as departmental policies and procedures. This position holds additional duties with respect to research, and participation in root cause analysis and identifying process improvements and communicating results to provide performance feedback and continuous refinement.
Responsibilities Leverages extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing to audit coded charts. Provide coding, financial and/or operational reports, and provide feedback to improve documentation to maximize revenue and reduce denials. Performs audits of the coding team, providing feedback and education based on results. Develops overall educational materials based on common trends identified during the audit process. Conducts internal coding audits and analysis of issues holding up accounts and follows guidelines. Identifies areas of utilization improvements and monitors expected outcomes. Identifies recurring problems and procedural deficiencies and provides solutions to eliminate them. Research and update new and/or revised coding and compliance standards. Performs other related duties as required or requested.
Qualifications High school diploma or equivalency AAPC Certified Professional Coder (CPC) certification is required. Other relevant certifications (CPMA, CEMC) are a plus. Maintain departmental productivity levels and compliance with quality standards. A minimum of 4 years of experience in a multi-specialty physician practice or clinic, coding multiple medical/surgical specialties/subspecialties. A minimum of 3 years of prior experience translating coding error trending and quality assurance and translating these results into process improvements with minimum supervision required. Advanced knowledge of ICD10, CPT and HCPCS coding guidelines, payer and governmental policies. Proficiency in using medical billing software and EHR systems. Attention to detail with the ability to identify/resolve problems and document the outcome. Ability to collaborate effectively in a team setting to maximize quality and efficiency of operations.
Location Oak Brook, Illinois (Remote) Department Quality Assurance Employment Type Full-Time Minimum Experience Mid-level Compensation $28-$32/HR