Senior Analyst, Quality

Remote Full-time
Job Description: • Responsible for conducting complex audits, reviews and assessments of medical records coded by internal teams prior to submission to CMS • Contributes to compliance reporting and documentation, highlighting findings, recommendations, and areas of concern to coding resources • Applies coding judgment and makes decisions using industry-standard evidence and tools • Confidently communicates evidence across internal or external stakeholders in written or verbal forms • Acts as mentor to provide education to internal staff based on audit findings • Communicates with corporate legal and compliance teams for accurate and timely reporting to external authorities • May liaison with regulatory bodies, auditors, and legal professionals for compliance-related matters • Demonstrates commitment to enhancing and promoting quality Requirements: • Minimum of 5 years recent and related experience in medical record documentation review, diagnosis coding, and/or auditing • Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) required • Completion of AAPC/AHIMA training program for core credential (CPC, CCS-P) with associated work history/on the job experience equal to approximately 5 years for CPC • CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment Coder) required • CPMA (Certified Professional Medical Auditor) or CDEO (Certified Documentation Expert Outpatient) preferred • Computer proficiency including experience with Microsoft Office products (Word, Excel, Access, PowerPoint, Outlook, industry standard coding applications) • Experience with International Classification of Disease (ICD) codes required Benefits: • Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching • Paid time off • Flexible work schedules • Family leave • Dependent care resources • Colleague assistance programs • Tuition assistance • Retiree medical access Apply tot his job
Apply Now

Similar Opportunities

Senior Claim Benefit Specialist

Remote Full-time

MEP Site Engineer

Remote Full-time

Accounting Manager, Property Accounting - Fixed Assets

Remote Full-time

Your Target Career Starts Here: Part-Time Remote Guest Services & E-Commerce Support

Remote Full-time

Data Engineer - Owned Brands Wholesale

Remote Full-time

Sr Logistics Analyst (Hybrid)

Remote Full-time

Director Performance & Insights, Roundel

Remote Full-time

Engineer - iOS job at Target in Brooklyn Park, MN

Remote Full-time

Senior Director Product Design - Kids and Newborn, Infant, Toddler (NIT)

Remote Full-time

Lead Field Implementation Business Partner

Remote Full-time

Denials Prevention Specialist, Clinician PRN

Remote Full-time

Peer Support Specialist - Fully Remote in Roswell, New Mexico

Remote Full-time

Accounting Clerk (Entry-Level) in Northbrook, IL

Remote Full-time

Facility Supervisor – Apple Valley Community Center – City of Apple Valley – Apple Valley, MN

Remote Full-time

Experienced Customer Experience Team Lead – Driving Exceptional User Engagement at blithequark

Remote Full-time

Experienced Customer Service Representative – Retail and Sales Expert

Remote Full-time

Experienced Customer Service and Data Entry Representatives Wanted for Remote Work Opportunities at blithequark

Remote Full-time

Experienced Remote Data Entry Specialist – Join the blithequark Team and Contribute to the Magic of Data Management from the Comfort of Your Own Home

Remote Full-time

Experienced Part-Time Personal Assistant – Remote Data Entry and Administrative Support Specialist

Remote Full-time

Experienced Online Research Participant – Flexible Data Entry and Survey Opportunities at blithequark

Remote Full-time
← Back to Home